Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01461 | Date 20/04/2020 |
| Token No | SM/19-20/3880 20/04/2020 | Serial | 011 |
| Patient Name | Mrs. MAYA DAS | Contact No | 8777514380 |
| Address | 22/Y/21 F D ROAD SERAMPORE MALLICKPARA 712203 | Age | 87 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||