Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00263 | Date 27/09/2019 |
| Token No | SM/19-20/1614 17/01/2020 | Serial | 013 |
| Patient Name | Mrs. PREMLATA YADAV | Contact No | 8820249122 |
| Address | GHORAMARA,SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||