Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00398 | Date 19/11/2019 |
| Token No | SM/19-20/2403 18/02/2020 | Serial | 039 |
| Patient Name | Mr. SK SAHAJAN | Contact No | 8697156966 |
| Address | 7 NO TARAPUKUR LANE CHAKAPARA SERAMPORE 712203 | Age | 51 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||