Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00109 | Date 13/09/2019 |
| Token No | SM/19-20/846 25/11/2019 | Serial | 032 |
| Patient Name | Mrs. BINA SHAW | Contact No | 9804669250 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||