Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 02664 | Date 30/07/2019 |
| Token No | SM/18-19/5282 30/07/2019 | Serial | 047 |
| Patient Name | Mrs. NUPUR PAL | Contact No | 9874463591 |
| Address | 3/159 MAHESh cOLONY | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||