Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00512 | Date 06/12/2019 |
| Token No | SM/19-20/984 06/12/2019 | Serial | 005 |
| Patient Name | Mrs. ALPANA MAJUMDER | Contact No | 9883987891 |
| Address | 65/25/37 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE | Age | 57 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||