Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01327 | Date 30/11/2018 |
| Token No | SM/18-19/3234 16/04/2019 | Serial | 003 |
| Patient Name | Miss SANKARI BANERJEE | Contact No | 9748165347 |
| Address | 148 N N COLONY | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||