Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01064 | Date 24/02/2020 |
| Token No | SM/19-20/2701 28/02/2020 | Serial | 040 |
| Patient Name | Mrs. BHARATI MALAKAR | Contact No | 6291016208 |
| Address | 34 NO TARAPUKUR LANE SERAMPORE 712203 | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||