Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00126 | Date 13/09/2019 |
| Token No | SM/19-20/136 13/09/2019 | Serial | 035 |
| Patient Name | Mrs. PUTUL MAJHI | Contact No | 8583026709 |
| Address | 195 NEW MAHESH SERAMPORE 712203 | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||