Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01106 | Date 28/02/2020 |
| Token No | SM/19-20/2689 28/02/2020 | Serial | 028 |
| Patient Name | Mrs. PREMA HELA | Contact No | |
| Address | L/24 WELLINGTON JUTE MILL LINE RISHRA 712248 | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||