Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03299 | Date 25/10/2019 |
| Token No | SM/18-19/7179 25/10/2019 | Serial | 015 |
| Patient Name | Miss TANNI MUKHERJEE | Contact No | 8910907556 |
| Address | 10 CHATTERJEE LANE DEY STREET | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||