Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02392 | Date 01/07/2019 |
| Token No | SM/18-19/4568 01/07/2019 | Serial | 031 |
| Patient Name | Mrs. FALGUNI MUKHERJEE | Contact No | 9830705150 |
| Address | 12A CHATTERJEE LANE | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||