Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00091 | Date 12/09/2019 |
| Token No | SM/19-20/97 12/09/2019 | Serial | 014 |
| Patient Name | Mrs. KRISHNA BAIRAGI | Contact No | 7605879091 |
| Address | 9 SANI PARA BYE LANE MALLICKPARA SERAMPORE 712203 | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||