Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00631 | Date 31/12/2019 |
| Token No | SM/19-20/1461 08/01/2020 | Serial | 009 |
| Patient Name | Mrs. CHINU GHOSH | Contact No | 8274937953 |
| Address | DAKSHIN RAJYADHARPUR SERAMPORE | Age | 51 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||