Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00888 | Date 07/02/2020 |
| Token No | SM/19-20/2063 07/02/2020 | Serial | 028 |
| Patient Name | Mrs. SHANTI DEBI KHADOYAR | Contact No | 6289882293 |
| Address | DINEN BHATTACHARJEE SARANI PRABASHNAGAR SERAMPORE | Age | 57 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||