Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00338 | Date 05/11/2019 |
| Token No | SM/19-20/1012 07/12/2019 | Serial | 004 |
| Patient Name | Mrs. KRISHNA KOLEY | Contact No | 7890941669 |
| Address | GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||