Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00948 | Date 14/02/2020 |
| Token No | SM/19-20/2243 14/02/2020 | Serial | 028 |
| Patient Name | Miss MOUSUMI KUMARI | Contact No | 9804308863 |
| Address | 122 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 18 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||