Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01194 | Date 16/03/2020 |
| Token No | SM/19-20/3135 16/03/2020 | Serial | 035 |
| Patient Name | Mrs. MARIA SAIMUN | Contact No | |
| Address | 58/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||