Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00718 | Date 10/01/2020 |
| Token No | SM/19-20/1534 10/01/2020 | Serial | 028 |
| Patient Name | Mrs. SUJATA DAS | Contact No | 9674859286 |
| Address | 24/A GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 43 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||