Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00200 | Date 20/09/2019 |
| Token No | SM/19-20/446 22/10/2019 | Serial | 015 |
| Patient Name | Mrs. BASANTI ADHIKARI | Contact No | 9874121683 |
| Address | SUKANTA PALLY PRABASHNAGAR SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||