Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00878 | Date 07/02/2020 |
| Token No | SM/19-20/3812 16/04/2020 | Serial | 009 |
| Patient Name | Mrs. GOURI BANERJEE | Contact No | 6291894954 |
| Address | 35 RISHI BANKIM SARANI PURBA SERAMPORE | Age | 75 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||