Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00317 | Date 01/11/2019 |
| Token No | SM/19-20/510 01/11/2019 | Serial | 006 |
| Patient Name | Mrs. REBA DAS | Contact No | 9330817046 |
| Address | 8/A/2 PRABASHNAGAR SERAMPORE 712249 | Age | 70 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||