Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00976 | Date 17/02/2020 |
| Token No | SM/19-20/3566 01/04/2020 | Serial | 007 |
| Patient Name | Mrs. REKHA GHOSHAL | Contact No | 9062979315 |
| Address | PURBAPARA GHORAMARA MALLICKPARA 712203 | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||