Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01486 | Date 27/04/2020 |
| Token No | SM/19-20/3920 27/04/2020 | Serial | 002 |
| Patient Name | Mr. SK JUMMAN ALI | Contact No | 7685044192 |
| Address | 18/A MIAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 44 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||