Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00003 | Date 05/09/2019 |
| Token No | SM/19-20/3 05/09/2019 | Serial | 003 |
| Patient Name | Mrs. ASMA BIBI | Contact No | 7047023587 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||