Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00229 | Date 25/08/2018 |
| Token No | SM/18-19/1894 06/12/2018 | Serial | 013 |
| Patient Name | Miss DAMAYANTI BISWAL | Contact No | NOT GIVEN |
| Address | SERAMPORE | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||