Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03467 | Date 22/11/2019 |
| Token No | SM/18-19/7650 22/11/2019 | Serial | 009 |
| Patient Name | Miss PUNAM DAS | Contact No | 8697840727 |
| Address | 16 KAILASH CHATTERJEE LANE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||