Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00485 | Date 29/11/2019 |
| Token No | SM/19-20/2827 05/03/2020 | Serial | 011 |
| Patient Name | Mrs. CHANDANA KOLEY | Contact No | 9062304792 |
| Address | GHORAMARA SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||