Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 00933 | Date 12/02/2020 |
| Token No | SM/19-20/2281 15/02/2020 | Serial | 015 |
| Patient Name | Mrs. LABONI MANNA | Contact No | 9062310583 |
| Address | 54/A SASHI BHUSION GHOSH LANE SERAMPORE 712202 | Age | 28 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||