Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00213 | Date 21/09/2019 |
| Token No | SM/19-20/687 15/11/2019 | Serial | 023 |
| Patient Name | Mrs. SHIPRA DAS | Contact No | 9088142803 |
| Address | PANDIT SATGHARA SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||