Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02529 | Date 22/07/2019 |
| Token No | SM/18-19/4919 22/07/2019 | Serial | 012 |
| Patient Name | Mrs. SADHANA SHIL | Contact No | 6289265916 |
| Address | TALPUKUR LOKENATHPOLLY | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||