Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 00917 | Date 10/02/2020 |
| Token No | SM/22-23/8996 20/05/2023 | Serial | 021 |
| Patient Name | Mrs. CHANDRABATI DEBI SHAW | Contact No | 8100144652 |
| Address | 70/A/2/92/1 KHATIR BAZAR LANE SERAMPORE 712202 | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||