Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00318 | Date 28/08/2018 |
| Token No | SM/18-19/353 28/08/2018 | Serial | 020 |
| Patient Name | Mrs. LIPIKA DAS | Contact No | |
| Address | CHATTERJEE LANE | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||