Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02472 | Date 15/07/2019 |
| Token No | SM/18-19/4943 22/07/2019 | Serial | 036 |
| Patient Name | Mrs. TUMPA PAL | Contact No | 9088467277 |
| Address | 22/B KAILASH CHATTERJEE LANE | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||