Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00359 | Date 08/11/2019 |
| Token No | SM/19-20/614 08/11/2019 | Serial | 014 |
| Patient Name | Mrs. NISHA KUMARI | Contact No | 9163549474 |
| Address | 122/B PRAVASHNAGAR SERAMPORE 712249 | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||