Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01127 | Date 05/03/2020 |
| Token No | SM/19-20/3707 09/04/2020 | Serial | 010 |
| Patient Name | Mrs. SUSMITA SARKAR | Contact No | 6291988860 |
| Address | 3/2 K C MUKHERJEE STREET BAIDYABATI M CHATRA 712204 | Age | 44 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||