Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00220 | Date 23/09/2019 |
| Token No | SM/19-20/284 23/09/2019 | Serial | 003 |
| Patient Name | Mrs. SUTAPA RANI CHOWDHURY | Contact No | 8420168366 |
| Address | 13/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||