Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02283 | Date 17/06/2019 |
| Token No | SM/19-20/8812 14/07/2020 | Serial | 010 |
| Patient Name | Mrs. BABY SHRIMANI.. | Contact No | 9903757687 |
| Address | 2/B/2 A K C BHATTACHARYA ST | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||