Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02271 | Date 14/06/2019 |
| Token No | SM/18-19/4183 14/06/2019 | Serial | 041 |
| Patient Name | Mrs. PAMPA BHATTACHARYA | Contact No | NOT GIVEN |
| Address | 17 G.T. ROAD | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||