Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00841 | Date 03/02/2020 |
| Token No | SM/19-20/1925 03/02/2020 | Serial | 001 |
| Patient Name | Mrs. ATIPHA BIBI | Contact No | 9163262648 |
| Address | 33 MIAJAN DARJEE LANE SERAMPORE MALLICKPARA 712203 | Age | 52 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||