Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00781 | Date 21/01/2020 |
| Token No | SM/19-20/1714 21/01/2020 | Serial | 026 |
| Patient Name | Mrs. RENU RAJAK | Contact No | 9088316969 |
| Address | 18/E HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||