Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01707 | Date 22/02/2019 |
| Token No | SM/18-19/5101 25/07/2019 | Serial | 006 |
| Patient Name | Mrs. KALPANA SARKAR | Contact No | 8478981317 |
| Address | NABAGRAM BHATTACHARYA GARDEN | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||