Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01708 | Date 22/02/2019 |
| Token No | SM/18-19/6870 10/10/2019 | Serial | 009 |
| Patient Name | Mrs. ANNA SARKAR | Contact No | 6290148295 |
| Address | 17 KAILASH CHATTERJEE LANE | Age | 63 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||