Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00992 | Date 17/02/2020 |
| Token No | SM/19-20/2358 17/02/2020 | Serial | 053 |
| Patient Name | Mrs. SUDHARANI DAS | Contact No | |
| Address | 43/32/D PRABASHNAGAR SERAMPORE M 712249 | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||