Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01512 | Date 29/04/2020 |
| Token No | SM/19-20/3974 29/04/2020 | Serial | 008 |
| Patient Name | Mrs. ANJALI ROY | Contact No | 8240873542 |
| Address | 7 NO TARAPUKUR LANE SERAMPORE 712203 | Age | 58 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||