Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01165 | Date 13/03/2020 |
| Token No | SM/19-20/3562 01/04/2020 | Serial | 003 |
| Patient Name | Mrs. SHEFALI CHAKRABORTY | Contact No | 7044765580 |
| Address | 32/D TARAPUKUR LANE SERAMPORE 712203 | Age | 97 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||