Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01125 | Date 04/03/2020 |
| Token No | SM/19-20/3491 28/03/2020 | Serial | 014 |
| Patient Name | Mrs. MALA BANIK | Contact No | 9339669471 |
| Address | 26/B PRABASHNAGAR SERAMPORE 712249 | Age | 57 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||