Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00989 | Date 17/02/2020 |
| Token No | SM/19-20/3032 13/03/2020 | Serial | 010 |
| Patient Name | Mrs. SISHU BALA GHOSH | Contact No | 7044152117 |
| Address | 43/14/4 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||