Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00419 | Date 23/11/2019 |
| Token No | SM/19-20/781 23/11/2019 | Serial | 002 |
| Patient Name | Mrs. LOTIKA DAS | Contact No | |
| Address | PROVASNAGER SERAMPORE | Age | 55 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||