Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00365 | Date 14/11/2019 |
| Token No | SM/19-20/3767 13/04/2020 | Serial | 033 |
| Patient Name | Mrs. DOLI DAS | Contact No | 9836966583 |
| Address | 173 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||