Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00405 | Date 19/11/2019 |
| Token No | SM/19-20/732 19/11/2019 | Serial | 012 |
| Patient Name | Mrs. GITA SHAW | Contact No | 9062932108 |
| Address | 151 NEW MAHESH SERAMPORE 712203 | Age | 37 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||