Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00104 | Date 13/09/2019 |
| Token No | SM/19-20/3371 24/03/2020 | Serial | 002 |
| Patient Name | Mrs. SHIBANI GHOSH | Contact No | 9804461714 |
| Address | 32/32A TARAPUKUR COLONY,SERAMPORE 712203 | Age | 82 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||