Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02210 | Date 10/06/2019 |
| Token No | SM/18-19/4037 10/06/2019 | Serial | 005 |
| Patient Name | Mrs. GOPA CHATTERJEE | Contact No | NOT GIVEN |
| Address | J.N. LAHIRI | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||