Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00304 | Date 25/10/2019 |
| Token No | SM/19-20/1194 20/12/2019 | Serial | 010 |
| Patient Name | Mrs. RAMRATI JAISWAL | Contact No | 9903882270 |
| Address | PRABASHNAGAR SERAMPORE 712249 | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||