Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00708 | Date 10/01/2020 |
| Token No | SM/19-20/1510 10/01/2020 | Serial | 004 |
| Patient Name | Mrs. RAJNI SHAW | Contact No | |
| Address | 79 NEW MAHESH SERAMPORE 712203 | Age | 23 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||