Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00848 | Date 03/02/2020 |
| Token No | SM/19-20/3059 13/03/2020 | Serial | 037 |
| Patient Name | Mrs. ATASI PAL | Contact No | 9163572130 |
| Address | 22/B2I FIRINGI DANGA ROAD SERAMPORE 712203 | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||