Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00129 | Date 16/09/2019 |
| Token No | SM/19-20/139 16/09/2019 | Serial | 003 |
| Patient Name | Mrs. KAJAL MALIK | Contact No | 8274034807 |
| Address | 2 TARAPUKUR COLONY MALLICKPARA SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||