Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01037 | Date 22/02/2020 |
| Token No | SM/19-20/3476 27/03/2020 | Serial | 025 |
| Patient Name | Mrs. SUMITRA SINGH | Contact No | 9748263061 |
| Address | GHORAMARA P SERAMPORE 712203 | Age | 65 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||