Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00698 | Date 09/01/2020 |
| Token No | SM/19-20/1481 09/01/2020 | Serial | 010 |
| Patient Name | Mrs. RAJNANDINI | Contact No | |
| Address | 9/A/2 TARAPUKUR SERAMPORE 712203 | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||