Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01491 | Date 27/04/2020 |
| Token No | SM/19-20/3930 27/04/2020 | Serial | 012 |
| Patient Name | Miss PALAK TANTI | Contact No | 7890662613 |
| Address | 97/N/8/C PRABASHNAGAR SERAMPORE 712249 | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||