Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03626 | Date 16/12/2019 |
| Token No | SM/19-20/8105 16/12/2019 | Serial | 036 |
| Patient Name | Mrs. ANNAPURNA DAS | Contact No | 8961582297 |
| Address | INDIA JUTE MILL SERAMPORE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||