Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00247 | Date 25/09/2019 |
| Token No | SM/19-20/335 25/09/2019 | Serial | 011 |
| Patient Name | Mrs. LAXMI MALAKAR | Contact No | 8697364267 |
| Address | 45 PRAVASHNAGAR SERAMPORE 712249 | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||