Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00038 | Date 07/09/2019 |
| Token No | SM/19-20/1377 03/01/2020 | Serial | 017 |
| Patient Name | Mrs. GURUPRIYA SHAW | Contact No | 9123980219 |
| Address | BIBIRBER SERAMPORE 712203 | Age | 68 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||