Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01318 | Date 29/11/2018 |
| Token No | SM/18-19/3001 02/04/2019 | Serial | 011 |
| Patient Name | Mrs. BIBHA BANERJEE | Contact No | 9830708322 |
| Address | 46/A THAKUR BATI STREET | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||