Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01242 | Date 20/03/2020 |
| Token No | SM/25-26/12408 27/12/2025 | Serial | 028 |
| Patient Name | Mrs. PAPIYA DAS | Contact No | 9433345823 |
| Address | 24/A/3/1 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 90/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||