Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00559 | Date 16/12/2019 |
| Token No | SM/19-20/3733 11/04/2020 | Serial | 013 |
| Patient Name | Mrs. ARCHANA DAS | Contact No | 9883266218 |
| Address | 65/25/23 WEST JANNAGAR ROAD SERAMPORE PRABASHNAGAR | Age | 69 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||