Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03442 | Date 20/11/2019 |
| Token No | SM/18-19/7573 20/11/2019 | Serial | 030 |
| Patient Name | Mrs. KALPANA NANDI | Contact No | NOT GIVEN |
| Address | BANERJEE PARA, SERAMPORE | Age | 36 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||