Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00553 | Date 13/12/2019 |
| Token No | SM/19-20/1097 13/12/2019 | Serial | 023 |
| Patient Name | Mrs. ALOKA PAL | Contact No | 9051109277 |
| Address | HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 82 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||