Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00635 | Date 31/12/2019 |
| Token No | SM/22-23/30 20/05/2022 | Serial | 028 |
| Patient Name | Mr. ANIL CHANDRA MALAKAR | Contact No | 8479981663 |
| Address | 34 B/27 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 88 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||