Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00695 | Date 09/01/2020 |
| Token No | SM/19-20/1477 09/01/2020 | Serial | 006 |
| Patient Name | Mrs. USHA YADAV | Contact No | |
| Address | B-89 TARAPUKUR GOVT QUARTER SERAMPORE 71220 3 | Age | 25 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||