Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00691 | Date 09/01/2020 |
| Token No | SM/19-20/1472 09/01/2020 | Serial | 001 |
| Patient Name | Mrs. JHUMA CHONGDER | Contact No | |
| Address | 65/A BAHIR SERAMPORE | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||