Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00040 | Date 07/09/2019 |
| Token No | SM/19-20/40 07/09/2019 | Serial | 018 |
| Patient Name | Mrs. KANTI DEBI BHAGAT | Contact No | 9339579565 |
| Address | 14/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||