Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01575 | Date 15/01/2019 |
| Token No | SM/18-19/7529 19/11/2019 | Serial | 026 |
| Patient Name | Mrs. SANTA CHAKRABORTY | Contact No | 8420589899 |
| Address | 121 NEHERU NAGAR COLONY | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 90 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||