Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02715 | Date 05/08/2019 |
| Token No | SM/18-19/5791 21/08/2019 | Serial | 008 |
| Patient Name | Mrs. JILEBA ROY | Contact No | 9062627142 |
| Address | SERAMPORE AKHRA BATI LANE | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||