Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02747 | Date 06/08/2019 |
| Token No | SM/18-19/5469 06/08/2019 | Serial | 048 |
| Patient Name | Mrs. RUMA SIL | Contact No | |
| Address | SRERAMPORE BANERJEE PARA | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||