Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01347 | Date 07/12/2018 |
| Token No | SM/18-19/4523 28/06/2019 | Serial | 013 |
| Patient Name | Mrs. TAPASI GANGULY | Contact No | 8902387046 |
| Address | 15 NO LIBRARY LANE | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||