Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00242 | Date 25/09/2019 |
| Token No | SM/19-20/326 25/09/2019 | Serial | 002 |
| Patient Name | Mrs. KUSMA DEBE | Contact No | 8335090624 |
| Address | 55NO ROYLAND ROAD SERAMPORE 712201 | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||