Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00760 | Date 18/01/2020 |
| Token No | SM/19-20/2126 08/02/2020 | Serial | 027 |
| Patient Name | Mrs. CHABI KOLEY | Contact No | 6289094385 |
| Address | 9/A TARAPUKUR LANE SERAMPORE 712203 | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||