Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00250 | Date 25/09/2019 |
| Token No | SM/19-20/338 25/09/2019 | Serial | 014 |
| Patient Name | Mr. SK SAHIL | Contact No | 7439998764 |
| Address | 23/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||