Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00623 | Date 28/12/2019 |
| Token No | SM/19-20/1297 28/12/2019 | Serial | 015 |
| Patient Name | Miss SABITA NAYEK | Contact No | 8961007554 |
| Address | HARIJAN BASTI B B GHOSH ROAD SERAMPORE 712203 | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||