Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01001 | Date 18/02/2020 |
| Token No | SM/19-20/2375 18/02/2020 | Serial | 011 |
| Patient Name | Mrs. REKHA ROY | Contact No | 8584948959 |
| Address | 7/A HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 54 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||