Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00453 | Date 25/11/2019 |
| Token No | SM/19-20/1075 13/12/2019 | Serial | 001 |
| Patient Name | Mrs. RASMONI MALAKAR | Contact No | |
| Address | PRAVASNAGAR SERAMPORE 712249 | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||