Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 00715 | Date 10/01/2020 |
| Token No | SM/19-20/1521 10/01/2020 | Serial | 015 |
| Patient Name | Mrs. ARATI MAJUMDER | Contact No | 9681206134 |
| Address | 22/K/3 JANNAGAR ROAD MAHESH SERAMPORE 712202 | Age | 59 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||