Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00411 | Date 20/11/2019 |
| Token No | SM/19-20/758 20/11/2019 | Serial | 001 |
| Patient Name | Mrs. KESONA ACHAYA | Contact No | |
| Address | PROVASNAGER SERAMPORE | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||