Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00738 | Date 17/01/2020 |
| Token No | SM/19-20/1602 17/01/2020 | Serial | 001 |
| Patient Name | Mr. SITAL BAG | Contact No | 7278438149 |
| Address | 6 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 57 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||