Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00618 | Date 28/12/2019 |
| Token No | SM/19-20/1385 04/01/2020 | Serial | 007 |
| Patient Name | Mrs. MINA SARKAR | Contact No | 9331010464 |
| Address | 65/25/49 WEST JANNAGAR ROAD PRABASHNAGAR SERAMPORE | Age | 59 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||