Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00122 | Date 13/09/2019 |
| Token No | SM/19-20/2742 02/03/2020 | Serial | 004 |
| Patient Name | Mrs. PRAVA DEBNATH | Contact No | 9681787646 |
| Address | 5/2 HARIPARA LANE SERAMPORE 712203 | Age | 84 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||