Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00319 | Date 28/08/2018 |
| Token No | SM/18-19/6964 17/10/2019 | Serial | 025 |
| Patient Name | Mrs. SHIKHA KARMAKAR | Contact No | 7044680744 |
| Address | KALITALA | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||