Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03029 | Date 12/09/2019 |
| Token No | SM/18-19/6372 12/09/2019 | Serial | 019 |
| Patient Name | Miss ILA KUMARI SHAW | Contact No | 9831552682 |
| Address | 83 DEY STREER SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||