Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 00080 | Date 12/09/2019 |
| Token No | SM/19-20/84 12/09/2019 | Serial | 001 |
| Patient Name | Mrs. KAJAL PAL | Contact No | 8420925488 |
| Address | 31 GANGULY BAGAN LANE,SERAMPORE 712202 | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||