Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01364 | Date 06/04/2020 |
| Token No | SM/19-20/3658 06/04/2020 | Serial | 011 |
| Patient Name | Mrs. GITA RABIDAS | Contact No | 7603083992 |
| Address | HARIJAN BASTI B B GHOSH ROAD SERAMPORE 712203 | Age | 35 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||