Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00260 | Date 27/09/2019 |
| Token No | SM/19-20/551 05/11/2019 | Serial | 019 |
| Patient Name | Mrs. MARANIBALA DEBNATH | Contact No | 7003342097 |
| Address | 43/27/A/10 PRAVASHNAGAR SERAMPORE 712249 | Age | 72 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||