Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00513 | Date 06/12/2019 |
| Token No | SM/19-20/1014 07/12/2019 | Serial | 006 |
| Patient Name | Mrs. KANTI DEBI | Contact No | 7003397782 |
| Address | 97/Z/5 PRABASHNAGAR SERAMPORE | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||