Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00007 | Date 06/09/2019 |
| Token No | SM/19-20/684 15/11/2019 | Serial | 020 |
| Patient Name | Mrs. TARARANI DAS | Contact No | 9330327481 |
| Address | 10G/1 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 84 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||