Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01167 | Date 13/03/2020 |
| Token No | SM/19-20/3036 13/03/2020 | Serial | 014 |
| Patient Name | Mrs. SONIYA DEVI SHAW | Contact No | 9163232066 |
| Address | 65A/17 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||