Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00517 | Date 06/12/2019 |
| Token No | SM/19-20/1004 06/12/2019 | Serial | 025 |
| Patient Name | Mrs. ANKITA SAHA | Contact No | 9088265326 |
| Address | 55A/16 MAHESH JANNAGAR ROAD SERAMPORE | Age | 11 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||