Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00455 | Date 14/08/2018 |
| Token No | SM/18-19/1441 09/10/2018 | Serial | 009 |
| Patient Name | Miss TWINKLE SARKAR | Contact No | 8017789968 |
| Address | 3/2 K. C MUKHERJEE STREET | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||