Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00963 | Date 15/02/2020 |
| Token No | SM/19-20/3278 19/03/2020 | Serial | 036 |
| Patient Name | Mrs. JAYANTI DAS | Contact No | 9231681988 |
| Address | 30/34 TARAPUKUR LANE SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||