Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00026 | Date 07/09/2019 |
| Token No | SM/19-20/401 30/09/2019 | Serial | 025 |
| Patient Name | Mrs. DIPALI SINGHA | Contact No | 8420144898 |
| Address | CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||