Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00672 | Date 06/01/2020 |
| Token No | SM/19-20/1423 06/01/2020 | Serial | 012 |
| Patient Name | Mr. SUBHAM GHOSH | Contact No | 9339327298 |
| Address | 56/A/1 MALLICKPARA LANE SERAMPORE 712203 | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||