Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00184 | Date 17/09/2019 |
| Token No | SM/19-20/481 25/10/2019 | Serial | 012 |
| Patient Name | Mrs. DULDULI BHATTACHARYA | Contact No | 9432010939 |
| Address | 141 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||