Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00015 | Date 06/09/2019 |
| Token No | SM/19-20/15 06/09/2019 | Serial | 012 |
| Patient Name | Mrs. RENUKA GOPE | Contact No | 9477930992 |
| Address | 168 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||