Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00435 | Date 23/11/2019 |
| Token No | SM/19-20/1095 13/12/2019 | Serial | 021 |
| Patient Name | Mrs. SHANKARI ROY | Contact No | 8918999304 |
| Address | 30/37 TARAPUKUR LANE SERAMPORE | Age | 66 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||