Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00793 | Date 24/01/2020 |
| Token No | SM/19-20/3470 27/03/2020 | Serial | 019 |
| Patient Name | Mrs. URMILA SHAW | Contact No | 9331070359 |
| Address | SHITALATALA STREET 1 RISHRA 712248 | Age | 54 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||