Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00412 | Date 20/11/2019 |
| Token No | SM/19-20/1111 14/12/2019 | Serial | 007 |
| Patient Name | Mrs. KANCHAN RABIDAS | Contact No | |
| Address | 183 B B GHOSH ROAD SERAMPORE 712203 | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||