Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02686 | Date 01/08/2019 |
| Token No | SM/18-19/5616 14/08/2019 | Serial | 006 |
| Patient Name | Mrs. SANJUKTA BAKSHI | Contact No | 9432543455 |
| Address | TARAKESWAR | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||