Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00656 | Date 04/01/2020 |
| Token No | SM/19-20/1387 04/01/2020 | Serial | 009 |
| Patient Name | Mrs. SOMA ADGIRI | Contact No | |
| Address | BAHIR SERAMPORE SERAMPORE | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||