Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01593 | Date 19/01/2019 |
| Token No | SM/18-19/2304 19/01/2019 | Serial | 001 |
| Patient Name | Mrs. KAKALI MUKHERJEE | Contact No | 9836290644 |
| Address | DOSTI LANE | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||