Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00639 | Date 31/12/2019 |
| Token No | SM/19-20/3395 25/03/2020 | Serial | 001 |
| Patient Name | Mrs. UMA SAHA | Contact No | 8420758763 |
| Address | 20/I PRABASHNAGAR SERAMPORE 712249 | Age | 62 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||