Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02236 | Date 11/06/2019 |
| Token No | SM/18-19/4097 11/06/2019 | Serial | 028 |
| Patient Name | Mrs. RITA MUKHERJEE | Contact No | 9163446450 |
| Address | 25B KAILASH CHATTERJE LANE | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||