Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00147 | Date 16/09/2019 |
| Token No | SM/19-20/159 16/09/2019 | Serial | 023 |
| Patient Name | Mrs. SULEKHA GHOSH | Contact No | 9836827511 |
| Address | B/108/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 53 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||