Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01135 | Date 11/10/2018 |
| Token No | SM/18-19/3756 21/05/2019 | Serial | 009 |
| Patient Name | Mrs. MINATI CHATTERJEE | Contact No | 8697353588 |
| Address | 107/B NEHERU NAGAR COLONY | Age | 53 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||