Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00783 | Date 21/01/2020 |
| Token No | SM/19-20/1914 01/02/2020 | Serial | 027 |
| Patient Name | Mrs. KHAMA SAMANTA | Contact No | 9831812182 |
| Address | 28 PRABASHNAGAR SERAMPORE 712249 | Age | 56 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||