Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01366 | Date 06/04/2020 |
| Token No | SM/19-20/3660 06/04/2020 | Serial | 013 |
| Patient Name | Mrs. SARADA DEVI | Contact No | 7044124774 |
| Address | 94/I/1 GURU GARDEN LANE PRABASHNAGAR SERAMPORE 712249 | Age | 54 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||