Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 01058 | Date 24/02/2020 |
| Token No | SM/19-20/2534 24/02/2020 | Serial | 039 |
| Patient Name | Mrs. MOUMITA DAS | Contact No | 7003410770 |
| Address | BAISHNAB PARA 2ND LANE SERAMPORE | Age | 37 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||