Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00157 | Date 16/09/2019 |
| Token No | SM/19-20/171 16/09/2019 | Serial | 035 |
| Patient Name | Mrs. ANJALI DUTTA | Contact No | 9073806041 |
| Address | 35/D B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||