Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00034 | Date 07/09/2019 |
| Token No | SM/19-20/421 30/09/2019 | Serial | 045 |
| Patient Name | Mrs. DIPA SAHA | Contact No | 9874290076 |
| Address | 35/A B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||