Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00638 | Date 31/12/2019 |
| Token No | SM/19-20/3285 20/03/2020 | Serial | 003 |
| Patient Name | Mrs. CHAPA KARMAKAR | Contact No | 9143210790 |
| Address | SOCIETY MATH MALLICKPARA SERAMPORE 712203 | Age | 63 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||