Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 01334 | Date 04/12/2018 |
| Token No | SM/18-19/3100 05/04/2019 | Serial | 014 |
| Patient Name | Mrs. PUTUL MALLICK | Contact No | 8697547087 |
| Address | 5/1/T DINABANDHU CHATTERJEE LANE | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||