Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03393 | Date 15/11/2019 |
| Token No | SM/18-19/7431 15/11/2019 | Serial | 030 |
| Patient Name | Mrs. MOUSUMI CHATTERJEE | Contact No | 9432087969 |
| Address | 4 RUDRA RAM PANDIT LANE | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||