Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00476 | Date 29/11/2019 |
| Token No | SM/19-20/901 29/11/2019 | Serial | 006 |
| Patient Name | Mrs. SUCITTARA DEY | Contact No | 7890281640 |
| Address | 13/8 BB GHOSH ROAD SARADA PALLIY SERAMPORE | Age | 55 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||