Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00148 | Date 16/09/2019 |
| Token No | SM/19-20/2870 06/03/2020 | Serial | 018 |
| Patient Name | Mrs. RUPALI BANERJEE | Contact No | 6291894954 |
| Address | 35 R B SARANI SERAMPORE 712201 | Age | 53 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||