Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00042 | Date 07/09/2019 |
| Token No | SM/19-20/42 07/09/2019 | Serial | 020 |
| Patient Name | Mrs. MINA DEVI BHARTI | Contact No | 6290502727 |
| Address | 97/H/5 PRABASHNAGAR SERAMPORE 712249 | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||