Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01034 | Date 20/02/2020 |
| Token No | SM/19-20/2459 20/02/2020 | Serial | 019 |
| Patient Name | Mr. BILTU ROY | Contact No | 7450962123 |
| Address | 35/A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 58 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||