Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00759 | Date 18/01/2020 |
| Token No | SM/19-20/1655 18/01/2020 | Serial | 005 |
| Patient Name | Mr. JEET DEY | Contact No | 6290808816 |
| Address | 30/40/A TARA PUKUR LANE SERAMPORE 712203 | Age | 24 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||