Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00964 | Date 15/02/2020 |
| Token No | SM/19-20/2502 24/02/2020 | Serial | 007 |
| Patient Name | Mrs. PUJA SANTRA | Contact No | 8670343116 |
| Address | 12/C TARAPUKUR LANE SERAMPORE 712203 | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||