Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02675 | Date 31/07/2019 |
| Token No | SM/18-19/5307 31/07/2019 | Serial | 015 |
| Patient Name | Mrs. SREERUPA GOSWAMI | Contact No | 8697390899 |
| Address | 107A THAKUR BATI STREET | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||