Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01123 | Date 04/03/2020 |
| Token No | SM/19-20/3565 01/04/2020 | Serial | 006 |
| Patient Name | Mrs. BASIRAN BIBI | Contact No | 9007741949 |
| Address | 23/A MIYAJAN DARJEE LANE SERAMPORE 712203 | Age | 83 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||