Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00667 | Date 04/01/2020 |
| Token No | SM/19-20/3374 24/03/2020 | Serial | 005 |
| Patient Name | Mrs. DIPTI NAG | Contact No | 7449911910 |
| Address | 30/66 TARAPUKUR COLONY SERAMPORE 712203 | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||