Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00622 | Date 28/12/2019 |
| Token No | SM/19-20/1296 28/12/2019 | Serial | 014 |
| Patient Name | Mrs. PARBATI NAYEK | Contact No | 9875440251 |
| Address | BLOCK A B B GHOSH ROAD SERAMPORE 712203 | Age | 67 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||