Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02608 | Date 25/07/2019 |
| Token No | SM/18-19/5117 25/07/2019 | Serial | 022 |
| Patient Name | Miss RIYA BHATTACHARJEE | Contact No | 9830989390 |
| Address | 19A VIVEKANANDA ROAD | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||