Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02949 | Date 30/08/2019 |
| Token No | SM/18-19/6216 04/09/2019 | Serial | 018 |
| Patient Name | Mrs. GITA APAT | Contact No | 7003504331 |
| Address | 44/B/5 NANI LAL BHATTACHARJEE STREET | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||