Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00071 | Date 11/09/2019 |
| Token No | SM/19-20/72 11/09/2019 | Serial | 002 |
| Patient Name | Mrs. RINKI DAS | Contact No | 9088888556 |
| Address | 139 TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||