Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01340 | Date 06/12/2018 |
| Token No | SM/18-19/5941 27/08/2019 | Serial | 021 |
| Patient Name | Mrs. SANDHYA BANERJEE | Contact No | 9432984867 |
| Address | 5/C PITAMBAR DEY LANE | Age | 66 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||