Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00187 | Date 17/09/2019 |
| Token No | SM/19-20/400 30/09/2019 | Serial | 024 |
| Patient Name | Mrs. SANDHYA PRAJAPATI | Contact No | 9748641593 |
| Address | 55 RAYLAND ROAD SERAMPORE 712201 | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||