Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00133 | Date 16/09/2019 |
| Token No | SM/19-20/711 16/11/2019 | Serial | 011 |
| Patient Name | Mrs. MIRA KOLEY | Contact No | 9062304792 |
| Address | GHORAMARA PURBAPARA RAJYADHARPUR SERAMPORE | Age | 78 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||