Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00972 | Date 15/02/2020 |
| Token No | SM/19-20/2291 15/02/2020 | Serial | 025 |
| Patient Name | Mrs. MANIDEEPA DHAM | Contact No | 9674251409 |
| Address | 31/B TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||