Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02742 | Date 06/08/2019 |
| Token No | SM/18-19/5461 06/08/2019 | Serial | 040 |
| Patient Name | Mrs. MALA BHATTACHARYA | Contact No | 9051554736 |
| Address | 107/A THAKUR BATI STREET | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||