Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02938 | Date 30/08/2019 |
| Token No | SM/18-19/7190 31/10/2019 | Serial | 007 |
| Patient Name | Mrs. RITU DEBI PATWA | Contact No | 9038696522 |
| Address | K M BHATTACHARYA STREET | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||