Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00030 | Date 07/09/2019 |
| Token No | SM/19-20/3438 26/03/2020 | Serial | 003 |
| Patient Name | Mrs. CHAMPA SARKAR | Contact No | 6289467707 |
| Address | 147 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||