Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01050 | Date 05/10/2018 |
| Token No | SM/18-19/1370 05/10/2018 | Serial | 011 |
| Patient Name | Mrs. SULEKHA CHATTERJEE | Contact No | 9836847666 |
| Address | 10 ANNADA BABU GARDEN LANE | Age | 71 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||