Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00747 | Date 17/01/2020 |
| Token No | SM/19-20/3468 27/03/2020 | Serial | 017 |
| Patient Name | Mrs. MANGALA DAS | Contact No | 9874011053 |
| Address | 65/14/2 GURU GARDEN ROAD PROVASNAGER SERAMPORE | Age | 70 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||