Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01542 | Date 01/05/2020 |
| Token No | SM/19-20/4028 01/05/2020 | Serial | 013 |
| Patient Name | Mrs. KHATEJA KHATUN | Contact No | |
| Address | 9 MIYA JAN DARJI LANE SERAMPORE 712203 | Age | 66 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||