Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03249 | Date 21/10/2019 |
| Token No | SM/18-19/7068 21/10/2019 | Serial | 035 |
| Patient Name | Mrs. CHANDANA CHAKRABORTY | Contact No | 9804795262 |
| Address | 634 KALITALA | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||