Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01148 | Date 11/03/2020 |
| Token No | SM/19-20/2963 11/03/2020 | Serial | 017 |
| Patient Name | Mrs. MITA MONDAL | Contact No | |
| Address | 30/D JHILPARA SERAMPORE PRABASHNAGAR 712249 | Age | 48 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||