Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00988 | Date 17/02/2020 |
| Token No | SM/19-20/2348 17/02/2020 | Serial | 043 |
| Patient Name | Mrs. MADHABI SHAW | Contact No | 8240873542 |
| Address | 34/B 2/2 B B GHOSH ROAD SUKANTA PALLY 712203 | Age | 64 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||