Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03309 | Date 31/10/2019 |
| Token No | SM/18-19/7209 31/10/2019 | Serial | 026 |
| Patient Name | Mrs. SONALI CHATTERJEE | Contact No | 8240936721 |
| Address | 27 PANDIT KALINATH BHATTACHARYA STREET | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||