Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00399 | Date 19/11/2019 |
| Token No | SM/19-20/725 19/11/2019 | Serial | 005 |
| Patient Name | Mrs. BASANTI BEGUM | Contact No | 9681878582 |
| Address | CHAKAPARA SERAMPORE | Age | 43 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||