Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00072 | Date 11/09/2019 |
| Token No | SM/19-20/329 25/09/2019 | Serial | 005 |
| Patient Name | Mrs. SUKUMARI SARKAR | Contact No | 9007935820 |
| Address | PRABASHNAGAR JHILPAR SERAMPORE 712249 | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||