Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00574 | Date 18/12/2019 |
| Token No | SM/19-20/1174 18/12/2019 | Serial | 010 |
| Patient Name | Mrs. RACHANA DEVI | Contact No | 6289686109 |
| Address | 65/A/8 PRAVASNAGER SERAMPORE 712249 | Age | 44 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||