Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00053 | Date 09/09/2019 |
| Token No | SM/19-20/53 09/09/2019 | Serial | 010 |
| Patient Name | Mrs. BULBULI BIBI | Contact No | 9339451431 |
| Address | 54/1 CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||