Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00176 | Date 18/08/2018 |
| Token No | SM/18-19/185 18/08/2018 | Serial | 021 |
| Patient Name | Mrs. SUHASINI DEVI | Contact No | |
| Address | SERAMPORE | Age | 36 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||