Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01713 | Date 22/02/2019 |
| Token No | SM/18-19/2658 01/03/2019 | Serial | 017 |
| Patient Name | Mrs. KRISHNA MUKHERJEE | Contact No | 9650746692 |
| Address | 101/A NEHERU NAGAR | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||