Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02914 | Date 27/08/2019 |
| Token No | SM/18-19/5963 27/08/2019 | Serial | 043 |
| Patient Name | Mrs. PADMA HARI | Contact No | NOT GIVEN |
| Address | KATAPOL, SERAMPORE | Age | 19 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||