Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00123 | Date 13/09/2019 |
| Token No | SM/19-20/1363 03/01/2020 | Serial | 003 |
| Patient Name | Miss PINKI DAS | Contact No | 9088484798 |
| Address | 2 NO RAJYADHARPUR GOVT COLONY,SERAMPORE 712203 | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||