Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00788 | Date 22/01/2020 |
| Token No | SM/19-20/1740 22/01/2020 | Serial | 020 |
| Patient Name | Mrs. MANJU JHA | Contact No | 6289514151 |
| Address | 9/433 PRABASHNAGAR SERAMPORE 712249 | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||