Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00137 | Date 16/09/2019 |
| Token No | SM/19-20/836 25/11/2019 | Serial | 022 |
| Patient Name | Mrs. GOURI DAS | Contact No | 9674251396 |
| Address | 5 DR B R AMBEDKAR LANE,SERAMPORE 712203 | Age | 44 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||