Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03273 | Date 22/10/2019 |
| Token No | SM/18-19/7125 22/10/2019 | Serial | 040 |
| Patient Name | Mrs. SHYAMALI GHOSH | Contact No | 9804012934 |
| Address | 48B MUKHERJEE PARA LANE | Age | 51 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||