Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00862 | Date 04/02/2020 |
| Token No | SM/19-20/1991 04/02/2020 | Serial | 028 |
| Patient Name | Mrs. SARASWATI DAS | Contact No | 9007950360 |
| Address | 55/A/12 WEST M J ROAD CHAKLAPARA PRABASHNAGAR 712203 | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||