Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00515 | Date 06/12/2019 |
| Token No | SM/19-20/999 06/12/2019 | Serial | 020 |
| Patient Name | Mr. SOUMYADIP GHOSH | Contact No | 9874330462 |
| Address | 56/A/1/A MALLICKPARA LANE SERAMPORE 712203 | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||