Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00999 | Date 18/02/2020 |
| Token No | SM/19-20/2373 18/02/2020 | Serial | 009 |
| Patient Name | Mrs. JAIBUNNESHA KHATUN | Contact No | 8981443008 |
| Address | 18 A K C BHATTACHARJEE STREET SERAMPORE 712201 | Age | 52 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||