Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02593 | Date 24/07/2019 |
| Token No | SM/18-19/7321 11/11/2019 | Serial | 005 |
| Patient Name | Mrs. PUJA MAITY | Contact No | 9679480054 |
| Address | 12 KAILASH CHATTERJEE LANE | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||