Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01111 | Date 02/03/2020 |
| Token No | SM/19-20/2743 02/03/2020 | Serial | 005 |
| Patient Name | Mrs. DIPA BHUIYA | Contact No | 9007795638 |
| Address | 48 NEW MAHESH SERAMPORE 712203 | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||