Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00705 | Date 10/01/2020 |
| Token No | SM/19-20/1507 10/01/2020 | Serial | 001 |
| Patient Name | Mrs. JHUMA ROY | Contact No | |
| Address | BIBIRBER SERAMPORE | Age | 39 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||