Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01110 | Date 29/02/2020 |
| Token No | SM/19-20/2738 29/02/2020 | Serial | 027 |
| Patient Name | Mrs. ANOWARA BEGUM | Contact No | 9051778242 |
| Address | 9 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||