Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00650 | Date 03/01/2020 |
| Token No | SM/19-20/1374 03/01/2020 | Serial | 014 |
| Patient Name | Mrs. PARBATI DAS | Contact No | 6289713414 |
| Address | 26/B PRABASHNAGAR SERAMPORE 712249 | Age | 78 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||