Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00700 | Date 09/01/2020 |
| Token No | SM/19-20/1484 09/01/2020 | Serial | 013 |
| Patient Name | Mrs. ANIMA BAG | Contact No | 6290680766 |
| Address | BAIDYABATI NISHIT SEN SARANI | Age | 42 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||