Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01031 | Date 20/02/2020 |
| Token No | SM/19-20/2456 20/02/2020 | Serial | 016 |
| Patient Name | Mrs. USHA MONDAL | Contact No | 8100414854 |
| Address | 148 UTTAR MONDAL PARA SIMLA SERAMPORE 712203 | Age | 26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||