Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00097 | Date 13/09/2019 |
| Token No | SM/19-20/413 30/09/2019 | Serial | 037 |
| Patient Name | Mrs. HANUFA BAGAM | Contact No | 7439384708 |
| Address | 71 MALLICKPARA LANE SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||