Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03007 | Date 06/09/2019 |
| Token No | SM/18-19/6277 06/09/2019 | Serial | 025 |
| Patient Name | Mrs. CHITRA DEY | Contact No | 9038636040 |
| Address | 32/C THAKUR BATI STREET | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||