Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00078 | Date 11/09/2019 |
| Token No | SM/19-20/448 22/10/2019 | Serial | 017 |
| Patient Name | Mrs. CHAITALI SAHA | Contact No | 7278099907 |
| Address | 25/30 B B GHOSH ROAD,PRABASHNAGAR 712203 | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||