Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01328 | Date 30/11/2018 |
| Token No | SM/18-19/2563 22/02/2019 | Serial | 006 |
| Patient Name | Mrs. SHARMILA SARKAR | Contact No | 6290148295 |
| Address | 17 KAILASH CHATTERJEE LANE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||