Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02106 | Date 23/05/2019 |
| Token No | SM/18-19/4666 08/07/2019 | Serial | 033 |
| Patient Name | Mrs. LAXMI DEBI | Contact No | NOT GIVEN |
| Address | 2 NO GOPAL GANGULY LANE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||