Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01435 | Date 16/04/2020 |
| Token No | SM/19-20/3807 16/04/2020 | Serial | 004 |
| Patient Name | Mr. SK MUSHA | Contact No | |
| Address | 9NO MALLICKPARA LANE SERAMPORE 712203 | Age | 48 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||