Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00569 | Date 18/12/2019 |
| Token No | SM/19-20/1167 18/12/2019 | Serial | 003 |
| Patient Name | Mrs. KIRAN DEVI | Contact No | 9875696228 |
| Address | 3/A MUCHI PARA LANE SERAMPORE | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||