Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00144 | Date 16/09/2019 |
| Token No | SM/19-20/156 16/09/2019 | Serial | 020 |
| Patient Name | Mrs. SHAKUNTALA KUMARI | Contact No | 8697934818 |
| Address | 253 NEW MAHESH SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||