Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01207 | Date 17/03/2020 |
| Token No | SM/19-20/3164 17/03/2020 | Serial | 012 |
| Patient Name | Mrs. ANOWARA BEGUM | Contact No | 6289257473 |
| Address | 23 MIYAJAN DARJEE LANE SERAMPORE 712203 | Age | 61 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||