Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00076 | Date 11/09/2019 |
| Token No | SM/19-20/435 22/10/2019 | Serial | 004 |
| Patient Name | Mrs. SUSHILA DEBI GUPTA | Contact No | 6289038656 |
| Address | 122 PRABASHNAGAR,SERAMPORE 712249 | Age | 65 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||