Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01833 | Date 28/03/2019 |
| Token No | SM/18-19/4342 21/06/2019 | Serial | 010 |
| Patient Name | Mrs. CHANDRANI BAG | Contact No | 8902650222 |
| Address | 4 A,B GARDEN LANE | Age | 66 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||