Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00459 | Date 26/11/2019 |
| Token No | SM/19-20/864 26/11/2019 | Serial | 004 |
| Patient Name | Mrs. BANHI MITRA | Contact No | 7980536074 |
| Address | 45/Y TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 51 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||