Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 00165 | Date 16/09/2019 |
| Token No | SM/19-20/180 16/09/2019 | Serial | 044 |
| Patient Name | Mrs. BABI DAS | Contact No | |
| Address | 70A J N LAHIRI ROAD SERAMPORE 712201 | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||