Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00390 | Date 16/11/2019 |
| Token No | SM/19-20/705 16/11/2019 | Serial | 005 |
| Patient Name | Mrs. KAROBI MALAKAR | Contact No | |
| Address | 31 TARA PUKUR LANE SERAMPORE | Age | 57 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||