Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01192 | Date 16/03/2020 |
| Token No | SM/19-20/3132 16/03/2020 | Serial | 032 |
| Patient Name | Mrs. SUKHI MOHALI | Contact No | 8420603577 |
| Address | SATGHARA PURBAPARA SERAMPORE 712203 | Age | 17 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||