Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00005 | Date 06/09/2019 |
| Token No | SM/19-20/1889 01/02/2020 | Serial | 002 |
| Patient Name | Mrs. DIPALI DAS | Contact No | 8697362580 |
| Address | 2 NO RAJYADHARPUR GOVT COLONY,SERAMPORE 712203 | Age | 73 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 180/80 mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||