Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00059 | Date 09/09/2019 |
| Token No | SM/19-20/59 09/09/2019 | Serial | 016 |
| Patient Name | Mrs. MAMATA DHARA | Contact No | 8420706296 |
| Address | VIVEK PALLY MALLICKPARA SERAMPORE 712203 | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 132/78 mmHg | Weight | 56 KG |
| Pulse Rate | 78 / min | Height | cm |
| Diagnosis | |||