Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 02679 | Date 01/08/2019 |
| Token No | SM/18-19/5319 01/08/2019 | Serial | 010 |
| Patient Name | Mrs. SOMA DEBNATH | Contact No | 9748362592 |
| Address | 311 MAHESH COLONY | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||