Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00626 | Date 30/12/2019 |
| Token No | SM/19-20/1304 30/12/2019 | Serial | 007 |
| Patient Name | Mr. SAILA PAL | Contact No | 9903240220 |
| Address | 2/A HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 53 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||