Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01402 | Date 13/04/2020 |
| Token No | SM/19-20/3752 13/04/2020 | Serial | 018 |
| Patient Name | Mrs. JAYMALA DAS | Contact No | |
| Address | 238 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 71 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||