Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01928 | Date 16/04/2019 |
| Token No | SM/18-19/5751 20/08/2019 | Serial | 019 |
| Patient Name | Miss SUBHRA BANERJEE | Contact No | NOT GIVEN |
| Address | 17 BHAGIRATHI LANE | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||