Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00189 | Date 17/09/2019 |
| Token No | SM/22-23/19374 04/03/2024 | Serial | 029 |
| Patient Name | Mrs. ITIKANA CHAKRABORTY DASGUPTA | Contact No | 9062574878 |
| Address | 167/X TARAPUKUR GOVT QUARTERS MALLICKPARA SERAMPORE 712203 | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||