Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01256 | Date 21/03/2020 |
| Token No | SM/19-20/3327 21/03/2020 | Serial | 003 |
| Patient Name | Mrs. RAI GOP | Contact No | 9330185597 |
| Address | 2 NO RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 4 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||