Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00084 | Date 12/09/2019 |
| Token No | SM/19-20/900 29/11/2019 | Serial | 005 |
| Patient Name | Mrs. CHITRALEKHA DEBI | Contact No | 9681242893 |
| Address | NEW POST OFFICE PRABASHNAGAR SERAMPORE 712249 | Age | 57 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||