Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00955 | Date 14/02/2020 |
| Token No | SM/19-20/2252 14/02/2020 | Serial | 037 |
| Patient Name | Mrs. JAMUNA JARIWALA | Contact No | 7596823884 |
| Address | 34/B/64 B B GHOSH ROAD MALLICKPARA SERAMPORE 712203 | Age | 68 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||