Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01146 | Date 11/03/2020 |
| Token No | SM/19-20/3480 28/03/2020 | Serial | 003 |
| Patient Name | Mrs. CHUMKI MANDAL | Contact No | 8240072614 |
| Address | 92/1 NABIN CHAKRABORTY LANE BAIDYABATI M 712204 | Age | 17 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||