Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00245 | Date 25/09/2019 |
| Token No | SM/19-20/3386 24/03/2020 | Serial | 017 |
| Patient Name | Mrs. ASHA KUMARI PRASAD | Contact No | 9163968426 |
| Address | 97/P/9 PRAVASHNAGAR SERAMPORE 712249 | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||