Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01390 | Date 11/04/2020 |
| Token No | SM/19-20/3727 11/04/2020 | Serial | 007 |
| Patient Name | Mrs. DIPALI DAS | Contact No | |
| Address | PRABASHNAGAR SOCIETY MATH SERAMPORE 712249 | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||