Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00196 | Date 19/09/2019 |
| Token No | SM/19-20/3243 19/03/2020 | Serial | 001 |
| Patient Name | Mrs. UMA DOLUI | Contact No | 9330472086 |
| Address | 38/A B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 68 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||