Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00763 | Date 20/01/2020 |
| Token No | SM/19-20/1676 20/01/2020 | Serial | 007 |
| Patient Name | Mrs. DIPSIKHA ROY | Contact No | 9330135641 |
| Address | 6 HARIPARA LANE SERAMPORE 712203 | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||