Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00956 | Date 14/02/2020 |
| Token No | SM/19-20/2255 14/02/2020 | Serial | 040 |
| Patient Name | Mrs. HASINA KHATUN | Contact No | 9433325361 |
| Address | 3/A TARAPUKUR LANE SERAMPORE 712203 | Age | 75 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||