Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00159 | Date 16/09/2019 |
| Token No | SM/19-20/173 16/09/2019 | Serial | 037 |
| Patient Name | Mrs. KALYANI DAS | Contact No | 8478865919 |
| Address | 173 RAJYADHARPUR GOVT QUARTER,SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||