Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00521 | Date 07/12/2019 |
| Token No | SM/19-20/1018 07/12/2019 | Serial | 010 |
| Patient Name | Mrs. BABLI DAS | Contact No | 9674251396 |
| Address | 5 DR B R AMBEDKAR LANE SERAMPORE | Age | 8 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||