Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00142 | Date 16/09/2019 |
| Token No | SM/19-20/3967 29/04/2020 | Serial | 001 |
| Patient Name | Mrs. ARATI PAL | Contact No | 7998312048 |
| Address | 53/X TARAPUKUR LANE GOVT QUARTER,SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||