Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01220 | Date 18/03/2020 |
| Token No | SM/19-20/3301 20/03/2020 | Serial | 019 |
| Patient Name | Mrs. LATIPAN BIBI | Contact No | 7685044192 |
| Address | 86 MALLICKPARA SERAMPORE 712203 | Age | 66 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||