Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03125 | Date 26/09/2019 |
| Token No | SM/18-19/6713 26/09/2019 | Serial | 024 |
| Patient Name | Mrs. NIRUPAMA NAYAK | Contact No | 8582936166 |
| Address | SERAMPORE COLLEGE | Age | 28 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||