Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00678 | Date 06/01/2020 |
| Token No | SM/19-20/1750 22/01/2020 | Serial | 030 |
| Patient Name | Mrs. TAPASI DAS | Contact No | 9123770071 |
| Address | 65/22/1 M J ROAD PRABASHNAGAR 712249 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||