Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00813 | Date 27/01/2020 |
| Token No | SM/19-20/2275 15/02/2020 | Serial | 009 |
| Patient Name | Mr. SAYAN DUTTA | Contact No | 6291355137 |
| Address | 65/20/A F D ROAD SERAMPORE MALLICKPARA 712203 | Age | 14 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||