Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00005 | Date 06/09/2019 |
| Token No | SM/19-20/488 26/10/2019 | Serial | 001 |
| Patient Name | Mrs. DIPALI DAS | Contact No | 8697362580 |
| Address | 2 NO RAJYADHARPUR GOVT COLONY,SERAMPORE 712203 | Age | 73 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||