Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00090 | Date 12/09/2019 |
| Token No | SM/19-20/548 05/11/2019 | Serial | 016 |
| Patient Name | Mrs. RITA HALDER | Contact No | 9330244855 |
| Address | 8/A/2/15 PRABASHNAGAR,SERAMPORE 712249 | Age | 30 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||