Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00689 | Date 08/01/2020 |
| Token No | SM/19-20/1467 08/01/2020 | Serial | 015 |
| Patient Name | Mrs. PRATIMA SHAW | Contact No | 9681931876 |
| Address | 224 NEW MAHESH SERAMPORE 712203 | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||