Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00768 | Date 20/01/2020 |
| Token No | SM/19-20/1716 21/01/2020 | Serial | 028 |
| Patient Name | Mrs. SANJU KUMARI | Contact No | |
| Address | NEW MAHESH KATAPOL SERAMPORE 712203 | Age | 11 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||