Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00138 | Date 16/09/2019 |
| Token No | SM/19-20/148 16/09/2019 | Serial | 012 |
| Patient Name | Mrs. RINKI DAS | Contact No | 8100414270 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 32 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||