Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00082 | Date 12/09/2019 |
| Token No | SM/19-20/3785 15/04/2020 | Serial | 012 |
| Patient Name | Mrs. ANJANA BHOWMICK | Contact No | 9830898339 |
| Address | 24J FIRINGI DANGA ROAD SERAMPORE 712203 | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||