Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01367 | Date 14/12/2018 |
| Token No | SM/18-19/1960 14/12/2018 | Serial | 002 |
| Patient Name | Miss SUPRITI MUKHERJEE | Contact No | 9836290644 |
| Address | 29 DOSTI LANE | Age | 21 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||