Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 01321 | Date 30/11/2018 |
| Token No | SM/18-19/1852 30/11/2018 | Serial | 005 |
| Patient Name | Mrs. RITA MAJUMDAR | Contact No | 7003706205 |
| Address | 16/I SATISH CHANDRA GHOSH LANE | Age | 58 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||