Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00509 | Date 05/12/2019 |
| Token No | SM/19-20/977 05/12/2019 | Serial | 004 |
| Patient Name | Mrs. CHANDA KUMARI | Contact No | 6299113385 |
| Address | 96/A PRAVASHNAGAR SERAMPORE 712249 | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||