Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01548 | Date 02/05/2020 |
| Token No | SM/19-20/4043 02/05/2020 | Serial | 009 |
| Patient Name | Mrs. SHANTI SHAW | Contact No | |
| Address | 30829D TARAPUKUR COLONY SUKANTA PALLY SERAMPORE 712203 | Age | 58 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||