Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00643 | Date 02/01/2020 |
| Token No | SM/19-20/1465 08/01/2020 | Serial | 013 |
| Patient Name | Mrs. SRIPORNA BANERJEE | Contact No | 6290939142 |
| Address | 30/3 TARAPUKUR LANE SERAMPORE 712203 | Age | 31 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||