Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00819 | Date 28/01/2020 |
| Token No | SM/19-20/1850 28/01/2020 | Serial | 005 |
| Patient Name | Mrs. CHANDRABATI PAL | Contact No | 8981349328 |
| Address | 2/C TARAPUKUR COLONY MALLICKPARA SERAMPORE 712203 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||