Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00115 | Date 13/09/2019 |
| Token No | SM/19-20/399 30/09/2019 | Serial | 023 |
| Patient Name | Mrs. LATIKA DAS | Contact No | 8481092715 |
| Address | 24/A/2/A MAHESH JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 72 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||