Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00195 | Date 17/08/2018 |
| Token No | SM/18-19/2206 04/01/2019 | Serial | 001 |
| Patient Name | Mrs. KAJAL SARKAR | Contact No | 9874304190 |
| Address | 2/3 K.C MUKHERJE STREET CHATRA, SERAMPORE | Age | 53 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||