Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00043 | Date 07/09/2019 |
| Token No | SM/19-20/43 07/09/2019 | Serial | 021 |
| Patient Name | Mrs. GITA DEVI SHAW | Contact No | 8100585081 |
| Address | GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||