Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00173 | Date 18/08/2018 |
| Token No | SM/18-19/182 18/08/2018 | Serial | 018 |
| Patient Name | Mrs. RIYA MUKHERJEE | Contact No | 8250745114 |
| Address | HARIPAL | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||