Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00822 | Date 28/01/2020 |
| Token No | SM/19-20/1863 28/01/2020 | Serial | 018 |
| Patient Name | Mrs. NAMITA DAS | Contact No | 7980852689 |
| Address | 32A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||