Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00536 | Date 11/12/2019 |
| Token No | SM/19-20/1056 11/12/2019 | Serial | 008 |
| Patient Name | Mrs. BULA SEAL | Contact No | 6289316244 |
| Address | 165/C PRABASHNAGAR SERAMPORE | Age | 19 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||