Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02065 | Date 16/05/2019 |
| Token No | SM/18-19/3672 16/05/2019 | Serial | 012 |
| Patient Name | Mrs. NAMITA MUKHERJEE | Contact No | 8617738711 |
| Address | SIRISHTALA | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||