Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00054 | Date 09/09/2019 |
| Token No | SM/19-20/1071 12/12/2019 | Serial | 012 |
| Patient Name | Mrs. DAYA DEVI PASWAN | Contact No | 8229926967 |
| Address | 97/W PRABASHNAGAR SERAMPORE 712249 | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||