Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00083 | Date 12/09/2019 |
| Token No | SM/19-20/87 12/09/2019 | Serial | 004 |
| Patient Name | Mrs. DEEPIKA DAS | Contact No | 6290005409 |
| Address | 24A/2/B GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||