Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00094 | Date 06/08/2018 |
| Token No | SM/18-19/1541 12/10/2018 | Serial | 014 |
| Patient Name | Mrs. DULARI RAJBHAR | Contact No | NOT GIVEN |
| Address | CHATTERJEE LANE, SERAMPORE | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||