Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 01576 | Date 15/01/2019 |
| Token No | SM/18-19/2283 15/01/2019 | Serial | 014 |
| Patient Name | Mrs. MOUBANI SIMLAI MUKHERJEE | Contact No | 8617728604 |
| Address | 11/C B L C M BYE LANE, MAHESH | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||