Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00238 | Date 24/09/2019 |
| Token No | SM/19-20/320 24/09/2019 | Serial | 029 |
| Patient Name | Mr. RAJA NAIR | Contact No | 9143191090 |
| Address | 12/E MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||