Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00799 | Date 25/01/2020 |
| Token No | SM/19-20/1798 25/01/2020 | Serial | 005 |
| Patient Name | Mrs. PURNIMA BHATTACHARYA | Contact No | 9163484128 |
| Address | 27 GT ROAD WEST MALLICKPARA SERAMPORE 712203 | Age | 51 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||