Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03274 | Date 22/10/2019 |
| Token No | SM/18-19/7126 22/10/2019 | Serial | 041 |
| Patient Name | Mrs. USHA DEVI | Contact No | |
| Address | 74 DEY STREET SRERAMPORE | Age | 33 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||