Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00161 | Date 16/09/2019 |
| Token No | SM/19-20/176 16/09/2019 | Serial | 040 |
| Patient Name | Mrs. DIPALI SANYAL | Contact No | 8334023628 |
| Address | 72A/3 PRAVASNAGAR SERAMPORE 712249 | Age | 53 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||