Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00275 | Date 30/09/2019 |
| Token No | SM/19-20/414 30/09/2019 | Serial | 038 |
| Patient Name | Mrs. GURIYA DEBI | Contact No | 6163155669 |
| Address | 32 NO B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||