Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02765 | Date 07/08/2019 |
| Token No | SM/18-19/5510 07/08/2019 | Serial | 026 |
| Patient Name | Mrs. SHARMILA BISWAS | Contact No | 9593038563 |
| Address | 90/C DEY STREET | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||