Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00911 | Date 08/02/2020 |
| Token No | SM/19-20/3392 24/03/2020 | Serial | 023 |
| Patient Name | Mrs. ANIMA KHATUN | Contact No | 9874913630 |
| Address | 6 CHAKAPARA MALLICKPARA SERAMPORE 712203 | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||