Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02740 | Date 06/08/2019 |
| Token No | SM/18-19/5458 06/08/2019 | Serial | 037 |
| Patient Name | Mrs. CHAMELI DAS | Contact No | 9830714596 |
| Address | 16D KAILASH CHATTERJEE LANE | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||