Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01247 | Date 20/03/2020 |
| Token No | SM/19-20/3977 29/04/2020 | Serial | 011 |
| Patient Name | Mrs. SANTANA SIULY | Contact No | 9231552763 |
| Address | 5/A TARAPUKUR COLONY SERAMPORE 712203 | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||