Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00342 | Date 05/11/2019 |
| Token No | SM/19-20/579 05/11/2019 | Serial | 047 |
| Patient Name | Mrs. MINA SINGH | Contact No | |
| Address | 97/K/3 PRAVASHNAGAR SERAMPORE 712249 | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||