Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00627 | Date 30/12/2019 |
| Token No | SM/19-20/1305 30/12/2019 | Serial | 008 |
| Patient Name | Mrs. ANKITA PAL | Contact No | 9062273808 |
| Address | 2/A HARIPARA LANE SERAMPORE 712203 | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||