Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 03093 | Date 23/09/2019 |
| Token No | SM/18-19/6997 18/10/2019 | Serial | 022 |
| Patient Name | Mr. KRIPANATH DEY | Contact No | NOT GIVEN |
| Address | 27 JANNAGAR ROAD | Age | 49 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||