Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01270 | Date 24/03/2020 |
| Token No | SM/19-20/3376 24/03/2020 | Serial | 007 |
| Patient Name | Mr. SAMIR MAJHI | Contact No | 8697353172 |
| Address | 6/A HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||