Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01109 | Date 29/02/2020 |
| Token No | SM/22-23/9362 08/06/2023 | Serial | 003 |
| Patient Name | Mrs. KANAN DAS | Contact No | 8584963976 |
| Address | 95/1 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||