Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00132 | Date 16/09/2019 |
| Token No | SM/19-20/1113 14/12/2019 | Serial | 009 |
| Patient Name | Mrs. ANITA DEBI | Contact No | 8017049459 |
| Address | A/A/97 PRABASHNAGAR SERAMPORE 712249 | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||