Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01284 | Date 16/11/2018 |
| Token No | SM/18-19/1772 16/11/2018 | Serial | 005 |
| Patient Name | Mrs. MINATI DEVNATH | Contact No | 9903235323 |
| Address | SEAMPORE NAGA, GHOSHAL PARA | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||