Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00520 | Date 07/12/2019 |
| Token No | SM/19-20/2290 15/02/2020 | Serial | 024 |
| Patient Name | Mrs. NILMANI DEVI JAISWARA | Contact No | 9163124289 |
| Address | 10/Q HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||