Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02863 | Date 21/08/2019 |
| Token No | SM/18-19/5785 21/08/2019 | Serial | 002 |
| Patient Name | Mrs. RENUKA SARKAR | Contact No | 6290780572 |
| Address | SERAMPORE COLONY | Age | 76 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||