Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00775 | Date 21/01/2020 |
| Token No | SM/19-20/2208 13/02/2020 | Serial | 012 |
| Patient Name | Mrs. JULI DEVI | Contact No | 8420616700 |
| Address | 9/433 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||