Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00635 | Date 07/09/2018 |
| Token No | SM/18-19/2470 14/02/2019 | Serial | 036 |
| Patient Name | Mrs. GARGI MUKHERJEE | Contact No | 9830908150 |
| Address | 19 KAILASH CHATTERJEE LANE | Age | 52 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||