Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00750 | Date 17/01/2020 |
| Token No | SM/19-20/1629 17/01/2020 | Serial | 028 |
| Patient Name | Mrs. JOLLY CHAKRABORTY | Contact No | 7044765580 |
| Address | 32/D TARAPUKUR LANE SERAMPORE 712203 | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||