Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00149 | Date 16/09/2019 |
| Token No | SM/19-20/1261 26/12/2019 | Serial | 001 |
| Patient Name | Mrs. DIPIKA DATTA | Contact No | 7003894118 |
| Address | 26/B PRABASHNAGAR,SERAMPORE 712249 | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||