Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00713 | Date 10/01/2020 |
| Token No | SM/19-20/1516 10/01/2020 | Serial | 010 |
| Patient Name | Miss SAMARPITA DEY | Contact No | 9088931242 |
| Address | 20/G/1 PRABASHNAGAR SERAMPORE 712249 | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||