Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01003 | Date 18/02/2020 |
| Token No | SM/19-20/2379 18/02/2020 | Serial | 015 |
| Patient Name | Mrs. BIMALA GIRI | Contact No | 8981252245 |
| Address | 165 NEW MAHESH SERAMPORE 712203 | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||