Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02158 | Date 03/06/2019 |
| Token No | SM/18-19/3927 03/06/2019 | Serial | 016 |
| Patient Name | Mrs. ILA PAL | Contact No | 9163219812 |
| Address | 2B KAILASH CHATTERJEE LANE | Age | 63 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||