Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00785 | Date 22/01/2020 |
| Token No | SM/19-20/1736 22/01/2020 | Serial | 016 |
| Patient Name | Mrs. RIJIYA BEGAM | Contact No | 9330883848 |
| Address | 14 TARAPUKUR LANE SERAMPORE MALLICKPARA 712203 | Age | 72 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||