Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 00077 | Date 11/09/2019 |
| Token No | SM/19-20/80 11/09/2019 | Serial | 010 |
| Patient Name | Mrs. MOUMITA DE | Contact No | 9831806266 |
| Address | 45/5 N K BANERJEE STREET RISHRA M 712248 | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||