Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00168 | Date 16/09/2019 |
| Token No | SM/19-20/185 16/09/2019 | Serial | 049 |
| Patient Name | Mrs. SOMA DAS | Contact No | 9749104527 |
| Address | B/99/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||