Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01977 | Date 25/04/2019 |
| Token No | SM/18-19/3393 25/04/2019 | Serial | 025 |
| Patient Name | Mrs. KALYANI KUNDU | Contact No | NOT GIVEN |
| Address | KALITALA | Age | 58 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||