Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01222 | Date 18/03/2020 |
| Token No | SM/19-20/3207 18/03/2020 | Serial | 009 |
| Patient Name | Mrs. PUTUL SAFIUDDIN BEGUM | Contact No | 7890402539 |
| Address | BARABELU MUSLIM PADA SERAMPORE BELUMILKI 712223 | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||