Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 03297 | Date 25/10/2019 |
| Token No | SM/18-19/7262 05/11/2019 | Serial | 014 |
| Patient Name | Mrs. MITHU GHOSH | Contact No | 8697361168 |
| Address | 12 DHARMATALA | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||