Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00361 | Date 08/11/2019 |
| Token No | SM/19-20/616 08/11/2019 | Serial | 016 |
| Patient Name | Mrs. MIRA PRAJAPATI | Contact No | 7044760984 |
| Address | 107/E/1 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||