Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00051 | Date 09/09/2019 |
| Token No | SM/19-20/1157 17/12/2019 | Serial | 026 |
| Patient Name | Mrs. SANDHYA SEN | Contact No | 9088229674 |
| Address | 20/A/9 PRABASHNAGAR SERAMPORE 712249 | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||