Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01623 | Date 07/02/2019 |
| Token No | SM/18-19/3809 27/05/2019 | Serial | 012 |
| Patient Name | Mrs. KALPANA BHATTACHARYA | Contact No | 9874391085 |
| Address | 117 G T ROAD, MANIKTALA | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||