Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00723 | Date 11/01/2020 |
| Token No | SM/19-20/1555 11/01/2020 | Serial | 009 |
| Patient Name | Mrs. SABITA MALAKAR | Contact No | 9748767052 |
| Address | 243 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 75 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||