Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00121 | Date 13/09/2019 |
| Token No | SM/19-20/1556 11/01/2020 | Serial | 010 |
| Patient Name | Mrs. RAMA ADHIKARI | Contact No | 8697362287 |
| Address | D N BHATTACHARYA SARANI PRABASHNAGAR SERAMPORE 712249 | Age | 53 YRS Female |
| Token For | Visit Doctor,Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||