Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00269 | Date 27/09/2019 |
| Token No | SM/19-20/372 27/09/2019 | Serial | 025 |
| Patient Name | Mrs. RAJESHWARI SAMADDAR | Contact No | 8777384561 |
| Address | 65/14/1B MAHESH JANNAGAR ROAD PRABASGNAGAR | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||