Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03259 | Date 22/10/2019 |
| Token No | SM/18-19/7420 15/11/2019 | Serial | 019 |
| Patient Name | Mrs. RINA MUKHERJEE | Contact No | 9836730023 |
| Address | 87 DEY STREET | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||