Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03255 | Date 21/10/2019 |
| Token No | SM/18-19/7081 21/10/2019 | Serial | 048 |
| Patient Name | Mrs. MOU MUKHERJEE | Contact No | 8479839825 |
| Address | 76/A R B SARANI | Age | 29 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||