Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02850 | Date 20/08/2019 |
| Token No | SM/18-19/5753 20/08/2019 | Serial | 021 |
| Patient Name | Miss SUSMITA KARMAKAR | Contact No | 9230129380 |
| Address | 105 J N LAHIRI ROAD | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||