Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00244 | Date 25/09/2019 |
| Token No | SM/19-20/331 25/09/2019 | Serial | 007 |
| Patient Name | Miss KOYEL SHARMA | Contact No | 9674744758 |
| Address | 43/24/2/A PRAVASHNAGAR SERAMPORE 712249 | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||