Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01131 | Date 11/10/2018 |
| Token No | SM/18-19/2584 22/02/2019 | Serial | 027 |
| Patient Name | Mrs. SUDHA MUKHERJEE | Contact No | 9804872696 |
| Address | 101/A NEHERU NAGAR COLONY | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||