Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02036 | Date 07/05/2019 |
| Token No | SM/18-19/3557 07/05/2019 | Serial | 011 |
| Patient Name | Mrs. DIPANNITA SUTRADHAR | Contact No | 9903646301 |
| Address | 53/D GHOSHAL PARA | Age | 34 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||