Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00186 | Date 17/09/2019 |
| Token No | SM/19-20/647 14/11/2019 | Serial | 020 |
| Patient Name | Mrs. LAXMI SHUILI | Contact No | 7449614610 |
| Address | 5/A TARAPUKUR COLONY,SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||