Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01457 | Date 18/04/2020 |
| Token No | SM/19-20/3864 18/04/2020 | Serial | 013 |
| Patient Name | Mrs. JYOTI BHUIYAN | Contact No | 7439256497 |
| Address | HARIJAN QUARTER B B GHOSH ROAD SERAMPORE 712203 | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||