Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00073 | Date 11/09/2019 |
| Token No | SM/19-20/3696 08/04/2020 | Serial | 008 |
| Patient Name | Mrs. RUBY DAS | Contact No | 9681931876 |
| Address | 34/B B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||