Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01382 | Date 09/04/2020 |
| Token No | SM/19-20/3813 16/04/2020 | Serial | 010 |
| Patient Name | Mr. JAGANNATH MUKHERJEE | Contact No | 6291894954 |
| Address | 55 RAMKRISHNA ROAD CHATRA BAIDYABATI M 712204 | Age | 62 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||