Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00262 | Date 27/09/2019 |
| Token No | SM/19-20/2685 28/02/2020 | Serial | 024 |
| Patient Name | Mrs. AMRITA YADAV | Contact No | 8820249122 |
| Address | GHORAMARA,PASCHIMPARA SERAMPORE 712203 | Age | 9 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||