Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00180 | Date 17/09/2019 |
| Token No | SM/19-20/205 17/09/2019 | Serial | 014 |
| Patient Name | Mr. MATA SARAN JAISWARA | Contact No | 9163124289 |
| Address | 10Q HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 73 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||