Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03240 | Date 21/10/2019 |
| Token No | SM/18-19/7049 21/10/2019 | Serial | 016 |
| Patient Name | Mrs. JYOTSNA NATH | Contact No | 9830016626 |
| Address | 50 AKHRA BATI LANE | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||