Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03306 | Date 31/10/2019 |
| Token No | SM/18-19/7199 31/10/2019 | Serial | 016 |
| Patient Name | Mrs. HIRA PAL | Contact No | NOT GIVEN |
| Address | NEAR SERAMPORE COLLEGE | Age | 71 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||