Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01223 | Date 26/10/2018 |
| Token No | SM/18-19/2320 22/01/2019 | Serial | 016 |
| Patient Name | Mrs. CHANDANA BHATTACHARYA | Contact No | 9433842733 |
| Address | 93B DEY STREET | Age | 67 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||