Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01789 | Date 15/03/2019 |
| Token No | SM/18-19/6024 30/08/2019 | Serial | 007 |
| Patient Name | Mrs. PURNIMA DUTTA | Contact No | 8335989944 |
| Address | KALITALA, SERAMPORE | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||