Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00967 | Date 15/02/2020 |
| Token No | SM/19-20/2282 15/02/2020 | Serial | 016 |
| Patient Name | Mrs. RIMA BHAGAT | Contact No | 8478895711 |
| Address | 64 JANNAGAR ROAD SERAMPORE 712203 | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||