Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 00088 | Date 12/09/2019 |
| Token No | SM/19-20/670 15/11/2019 | Serial | 006 |
| Patient Name | Mrs. BHAGABATI SHAW | Contact No | 9681207938 |
| Address | 1/B 25 C C ROAD EXTENSION RISHRA PRAVASHNAGAR | Age | 77 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||