Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00568 | Date 18/12/2019 |
| Token No | SM/19-20/3224 18/03/2020 | Serial | 026 |
| Patient Name | Mrs. SANDHYA KARMAKAR | Contact No | 9051848537 |
| Address | 65/24/4 GURU GARDEN ROAD PRABASHNAGAR 712249 | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||