Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00113 | Date 13/09/2019 |
| Token No | SM/19-20/175 16/09/2019 | Serial | 039 |
| Patient Name | Miss SNEHA SARKAR | Contact No | 9874260097 |
| Address | 9/A TARAPUKUR COLONY MALLICKPARA SERAMPORE 712203 | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||