Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00899 | Date 07/02/2020 |
| Token No | SM/19-20/2086 07/02/2020 | Serial | 051 |
| Patient Name | Miss RIMPA PATRA | Contact No | 8583997047 |
| Address | 5A JAMIDAR BAGAN LANE MALLICKPARA SERAMPORE 712203 | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||