Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00997 | Date 18/02/2020 |
| Token No | SM/19-20/2371 18/02/2020 | Serial | 007 |
| Patient Name | Mrs. SUMITA DULEY | Contact No | 7044609195 |
| Address | 12/B TARAPUKUR LANE SERAMPORE 712203 | Age | 64 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||