Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00973 | Date 15/02/2020 |
| Token No | SM/19-20/2957 11/03/2020 | Serial | 011 |
| Patient Name | Mrs. DURGAWATI DEVI | Contact No | |
| Address | 97/Z/3 PRABASHNAGAR SERAMPORE M 712249 | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||