Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01231 | Date 19/03/2020 |
| Token No | SM/19-20/3413 25/03/2020 | Serial | 019 |
| Patient Name | Miss TOSHBINA KHATUN | Contact No | 9330883848 |
| Address | 14 TARAPUKUR LANE SERAMPORE MALLICKPARA 712203 | Age | 14 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||