Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00116 | Date 13/09/2019 |
| Token No | SM/19-20/2169 12/02/2020 | Serial | 005 |
| Patient Name | Mrs. PUSPA MALAKAR | Contact No | 8697353380 |
| Address | 28/29 TARAPUKUR LANE,SERAMPORE 712203 | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||