Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00870 | Date 05/02/2020 |
| Token No | SM/19-20/2004 05/02/2020 | Serial | 011 |
| Patient Name | Mrs. JAYANTI SAMANTA | Contact No | |
| Address | 28 PRABASHNAGAR SERAMPORE 712249 | Age | 55 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||