Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02196 | Date 06/06/2019 |
| Token No | SM/18-19/4157 14/06/2019 | Serial | 015 |
| Patient Name | Mrs. SAKTI BHATTACHARYA | Contact No | 8420079601 |
| Address | THAKURBATI STREET | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||