Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00803 | Date 25/01/2020 |
| Token No | SM/19-20/1803 25/01/2020 | Serial | 010 |
| Patient Name | Mrs. BABY SHAW | Contact No | 6289048470 |
| Address | 10 RAM SITA LANE SERAMPORE | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||