Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00387 | Date 15/11/2019 |
| Token No | SM/19-20/700 15/11/2019 | Serial | 036 |
| Patient Name | Mrs. KALAWATI TIWARI | Contact No | |
| Address | SERAMPORE PRABASHNAGAR 712249 | Age | 72 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||