Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01514 | Date 29/04/2020 |
| Token No | SM/19-20/3976 29/04/2020 | Serial | 010 |
| Patient Name | Mrs. SUMITA SHAW | Contact No | 6291757994 |
| Address | 34B/2/2 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 25 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||