Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02552 | Date 19/07/2019 |
| Token No | SM/18-19/4974 19/07/2019 | Serial | 015 |
| Patient Name | Mrs. MIRA SINGH | Contact No | 7980236798 |
| Address | SERAMPORE PANCHU BABU BAZAR | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||