Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00990 | Date 17/02/2020 |
| Token No | SM/19-20/2995 12/03/2020 | Serial | 011 |
| Patient Name | Mrs. PRIYABALA BISWAS | Contact No | 8017957887 |
| Address | 49/O/3 PRABASHNAGAR SERAMPORE 712249 | Age | 70 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||