Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01554 | Date 02/05/2020 |
| Token No | SM/19-20/4050 02/05/2020 | Serial | 016 |
| Patient Name | Mrs. RUPA CHAKLADER | Contact No | 8420911581 |
| Address | 65/22/2 JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 49 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||