Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02156 | Date 31/05/2019 |
| Token No | SM/18-19/3903 31/05/2019 | Serial | 022 |
| Patient Name | Mrs. ANIMA GHOSH | Contact No | NOT GIVEN |
| Address | 48 DOSTI LANE | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||