Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00166 | Date 16/09/2019 |
| Token No | SM/19-20/181 16/09/2019 | Serial | 045 |
| Patient Name | Mr. SUMAN DAS | Contact No | 9875302596 |
| Address | 10/J HARIPRA LANE MALLICKPARA SERAMPORE 712203 | Age | 19 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||