Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00052 | Date 09/09/2019 |
| Token No | SM/19-20/52 09/09/2019 | Serial | 009 |
| Patient Name | Mrs. LAKHI DEVI | Contact No | 9123868490 |
| Address | 122 PRAVASHNAGAR SERAMPORE 712249 | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||