Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00356 | Date 08/11/2019 |
| Token No | SM/19-20/716 18/11/2019 | Serial | 001 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 9836050446 |
| Address | 4 G T ROAD HUMOR BAGAN MALLICKPARA SERAMPORE 712203 | Age | 74 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | 140/100 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||