Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01530 | Date 30/04/2020 |
| Token No | SM/19-20/4000 30/04/2020 | Serial | 009 |
| Patient Name | Mr. TAPAN DEBNATH | Contact No | 9038561402 |
| Address | 22/Y/21 F D ROAD NETAJI PALLY SERAMPORE 712203 | Age | 61 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||