Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00839 | Date 01/02/2020 |
| Token No | SM/19-20/1916 01/02/2020 | Serial | 029 |
| Patient Name | Mrs. KALPANA DUTTA | Contact No | 9051711720 |
| Address | 65/25/22/2 M.J ROAD SERAMPORE 712249 | Age | 58 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||