Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00334 | Date 05/11/2019 |
| Token No | SM/19-20/554 05/11/2019 | Serial | 022 |
| Patient Name | Mrs. KALPANA DAS | Contact No | 9239441178 |
| Address | 138 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 61 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||