Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01296 | Date 22/11/2018 |
| Token No | SM/18-19/1799 22/11/2018 | Serial | 008 |
| Patient Name | Mrs. KAKOLI MUKHERJEE | Contact No | 9836290644 |
| Address | 29 DOSTI LAMNE | Age | 49 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||