Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01209 | Date 17/03/2020 |
| Token No | SM/19-20/3168 17/03/2020 | Serial | 016 |
| Patient Name | Mrs. KALPANA PAL | Contact No | 8334972931 |
| Address | 315 MAHESH COLONY SERAMPORE MAHESH 712202 | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||