Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00867 | Date 05/02/2020 |
| Token No | SM/19-20/2000 05/02/2020 | Serial | 007 |
| Patient Name | Mrs. BINDU ROY | Contact No | 8250440832 |
| Address | 10/B HARIPARA LANE SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||