Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01555 | Date 04/05/2020 |
| Token No | SM/19-20/4054 04/05/2020 | Serial | 001 |
| Patient Name | Mrs. KAMALKALI NATH | Contact No | |
| Address | PRABASHNAGAR SERAMPORE 712249 | Age | 14 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||