Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00400 | Date 19/11/2019 |
| Token No | SM/19-20/726 19/11/2019 | Serial | 006 |
| Patient Name | Mrs. SURIYA BEGUM | Contact No | |
| Address | CHAKA PARA SERAMPORE | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||