Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00199 | Date 20/09/2019 |
| Token No | SM/22-23/9440 10/06/2023 | Serial | 009 |
| Patient Name | Mr. BISWANATH CHAKRABORTY | Contact No | 9681596074 |
| Address | 30/75 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||