Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00857 | Date 04/02/2020 |
| Token No | SM/19-20/3603 03/04/2020 | Serial | 003 |
| Patient Name | Mr. BIBHUPADA SARKAR | Contact No | 9874863723 |
| Address | 2 NO DOCTOR BAGAN LANE SERAMPORE 712203 | Age | 59 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||