Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01288 | Date 26/03/2020 |
| Token No | SM/19-20/3436 26/03/2020 | Serial | 001 |
| Patient Name | Mrs. BIUTY ROY | Contact No | |
| Address | 35 A TARA PUKUR LANE SERAMPORE | Age | 15 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||