Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00977 | Date 17/02/2020 |
| Token No | SM/19-20/2315 17/02/2020 | Serial | 010 |
| Patient Name | Miss SHREYA SARKAR | Contact No | 9874863723 |
| Address | 2 NO DOCTOR BAGAN LANE SERAMPORE 712201 | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||