Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00452 | Date 25/11/2019 |
| Token No | SM/19-20/843 25/11/2019 | Serial | 029 |
| Patient Name | Mrs. MINA SINGH | Contact No | 9874349043 |
| Address | 43/27/S/A GURU GARDEN ROAD PRAVASNAGER SERAMPORE 712249 | Age | 36 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||