Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02869 | Date 21/08/2019 |
| Token No | SM/18-19/5819 21/08/2019 | Serial | 036 |
| Patient Name | Mrs. KRISHNA MAITY | Contact No | 9733494650 |
| Address | 48/6 BHAGIRATHI LANE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||