Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02825 | Date 16/08/2019 |
| Token No | SM/18-19/5686 16/08/2019 | Serial | 054 |
| Patient Name | Mrs. ANANYA DASGUPATA | Contact No | 9002312356 |
| Address | 5 DEY STREET | Age | 27 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||