Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01526 | Date 27/12/2018 |
| Token No | SM/18-19/7593 21/11/2019 | Serial | 014 |
| Patient Name | Mrs. YASODA DEVI | Contact No | 8961821798 |
| Address | 7 DEY GHAT LANE | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||