Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00408 | Date 19/11/2019 |
| Token No | SM/19-20/920 29/11/2019 | Serial | 025 |
| Patient Name | Mrs. PUNAM SHAW | Contact No | 9903684370 |
| Address | 220 NEW MAHESH SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||