Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00272 | Date 30/09/2019 |
| Token No | SM/19-20/813 23/11/2019 | Serial | 034 |
| Patient Name | Mr. AMIT SINGH | Contact No | 6289926202 |
| Address | D-1/303 SUBASH NAGAR HOUSING PRAVASHNAGAR SERAMPORE 712249 | Age | 32 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||