Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00629 | Date 30/12/2019 |
| Token No | SM/19-20/1311 30/12/2019 | Serial | 014 |
| Patient Name | Mrs. DUKHI DEY | Contact No | |
| Address | PRABASHNAGAR SERAMPORE | Age | 75 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||