Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00258 | Date 27/09/2019 |
| Token No | SM/19-20/351 27/09/2019 | Serial | 004 |
| Patient Name | Mrs. PARBATI ORAO | Contact No | |
| Address | 1 HARIPARA LANE,SERAMPORE | Age | 70 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||