Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00039 | Date 07/09/2019 |
| Token No | SM/19-20/1777 24/01/2020 | Serial | 016 |
| Patient Name | Mrs. GOURI RANI DUTTA | Contact No | 8981509664 |
| Address | 24E TARAPUKUR LANE,SERAMPORE 712203 | Age | 72 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||