Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00469 | Date 27/11/2019 |
| Token No | SM/19-20/885 27/11/2019 | Serial | 001 |
| Patient Name | Mrs. MADHUMITA DOLUI | Contact No | 8274893362 |
| Address | 38/B B B GHOSH ROAD SERAMPORE 712203 | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||