Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01211 | Date 17/03/2020 |
| Token No | SM/19-20/3174 17/03/2020 | Serial | 022 |
| Patient Name | Mrs. SHUKLA SHARMA | Contact No | 9748867480 |
| Address | 34B/12 B B GHOSH ROAD SERAMPORE 712203 | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||