Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01325 | Date 30/11/2018 |
| Token No | SM/18-19/1860 30/11/2018 | Serial | 013 |
| Patient Name | Mrs. BONA BANERJEE | Contact No | 8697123709 |
| Address | 164B N.N. COLONY | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||