Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00896 | Date 07/02/2020 |
| Token No | SM/22-23/3669 21/10/2022 | Serial | 001 |
| Patient Name | Mrs. NILABATI SINGH | Contact No | 8918197639 |
| Address | 76 GURU GARDEN ROAD SUKANTA PALLY SERAMPORE 712249 | Age | 56 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||