Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01062 | Date 24/02/2020 |
| Token No | SM/19-20/2600 26/02/2020 | Serial | 005 |
| Patient Name | Mr. DIPAK GUHA | Contact No | 9331683331 |
| Address | 27/1 1NO RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 71 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 170/100 mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||