Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01049 | Date 24/02/2020 |
| Token No | SM/19-20/2512 24/02/2020 | Serial | 017 |
| Patient Name | Mrs. DIPTI DEY | Contact No | 9674784016 |
| Address | 26/C JANNAGAR ROAD PRABASHNAGAR 712249 | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||