Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01119 | Date 04/03/2020 |
| Token No | SM/19-20/2778 04/03/2020 | Serial | 009 |
| Patient Name | Mrs. KASHMIRA BEGUM | Contact No | 8961129410 |
| Address | 26/A MIYAJAN DARJEE LANE SERAMPORE 712203 | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||