Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00741 | Date 17/01/2020 |
| Token No | SM/19-20/1606 17/01/2020 | Serial | 005 |
| Patient Name | Miss SUSMITA SIL | Contact No | 9874996269 |
| Address | 165/B PRABASHNAGAR SERAMPORE 712249 | Age | 20 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||