Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01205 | Date 17/03/2020 |
| Token No | SM/19-20/3162 17/03/2020 | Serial | 010 |
| Patient Name | Mrs. KAKON ROY | Contact No | 7980734174 |
| Address | GHORAMARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||