Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01331 | Date 01/04/2020 |
| Token No | SM/19-20/3580 01/04/2020 | Serial | 021 |
| Patient Name | Mrs. PRIYANKA SHAW | Contact No | 8777540958 |
| Address | 59/E MALLICKPARA SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||