Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01208 | Date 17/03/2020 |
| Token No | SM/19-20/3165 17/03/2020 | Serial | 013 |
| Patient Name | Mrs. ANJOARA BIBI | Contact No | |
| Address | 23 MIYAJAN DARJEE LANE SERAMPORE 712203 | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||