Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 03143 | Date 30/09/2019 |
| Token No | SM/18-19/6780 30/09/2019 | Serial | 005 |
| Patient Name | Mrs. SABITA BHATTACHARJEE | Contact No | 9804876795 |
| Address | 10/A B L C MILLS ROAD | Age | Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||