Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00393 | Date 18/11/2019 |
| Token No | SM/19-20/1328 31/12/2019 | Serial | 011 |
| Patient Name | Miss SUMANA SAHA | Contact No | 9088265326 |
| Address | 55A/16 MAHESH JANNAGAR ROAD SERAMPORE M | Age | 14 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||