Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02757 | Date 07/08/2019 |
| Token No | SM/18-19/5499 07/08/2019 | Serial | 015 |
| Patient Name | Mrs. BABY KOLEY | Contact No | 9073177237 |
| Address | 45 A LALIT MOHON BHATTACHARYA STREET | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||