Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01323 | Date 30/11/2018 |
| Token No | SM/18-19/1855 30/11/2018 | Serial | 008 |
| Patient Name | Miss PRANATI CHAKRABORTY | Contact No | 8961668828 |
| Address | 1/2 CHATTERJEE LANE | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||