Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00012 | Date 06/09/2019 |
| Token No | SM/19-20/12 06/09/2019 | Serial | 009 |
| Patient Name | Mrs. DHIRA DAS | Contact No | 9903059560 |
| Address | 138 NO RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||