Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00817 | Date 27/01/2020 |
| Token No | SM/19-20/3213 18/03/2020 | Serial | 015 |
| Patient Name | Mr. SAHID MALLIK | Contact No | 6290168054 |
| Address | 33 MIAJAN DARJEE LANE SERAMPORE 712203 | Age | 57 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||