Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00292 | Date 22/10/2019 |
| Token No | SM/19-20/458 22/10/2019 | Serial | 027 |
| Patient Name | Mrs. USHA SHAW | Contact No | 9477541156 |
| Address | 29 NEW MAHESH SERAMPORE 712203 | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||