Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00329 | Date 05/11/2019 |
| Token No | SM/19-20/1134 17/12/2019 | Serial | 003 |
| Patient Name | Mrs. NURBANU BIBI | Contact No | 8100564474 |
| Address | 9 MALLICKPARA SERAMPORE 712203 | Age | 71 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||