Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00752 | Date 17/01/2020 |
| Token No | SM/19-20/1633 17/01/2020 | Serial | 032 |
| Patient Name | Mr. SANJAY SAHA | Contact No | 9804302827 |
| Address | 65/33 FIRINGI DANGA ROAD SERAMPORE 712203 | Age | 42 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||