Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00394 | Date 18/11/2019 |
| Token No | SM/19-20/3514 30/03/2020 | Serial | 007 |
| Patient Name | Mrs. RINA CHAKRABORTY | Contact No | 8478917190 |
| Address | 19 NEW MAHESH | Age | 40 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||