Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01021 | Date 19/02/2020 |
| Token No | SM/22-23/9292 03/06/2023 | Serial | 011 |
| Patient Name | Mrs. RASMANI DAS | Contact No | 9883665354 |
| Address | 34/39 GURU GARDEN ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||