Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01663 | Date 14/02/2019 |
| Token No | SM/18-19/2455 14/02/2019 | Serial | 021 |
| Patient Name | Mrs. MADHABI DEBNATH | Contact No | 9903142444 |
| Address | BIBIR BEL KOURIR BAGAN,SERAMPORE | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||