Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00592 | Date 21/12/2019 |
| Token No | SM/19-20/1571 14/01/2020 | Serial | 005 |
| Patient Name | Mrs. RASHIKA HARIJAN | Contact No | 7603100116 |
| Address | 13 B L 16 NO ROAD BHATPARA KAKINARA 743126 | Age | 19 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||