Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01273 | Date 24/03/2020 |
| Token No | SM/19-20/3384 24/03/2020 | Serial | 015 |
| Patient Name | Mrs. RUPA MAJHI | Contact No | |
| Address | HUMOR BAGAN LANE SERAMPORE 712203 | Age | 44 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||