Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00177 | Date 18/08/2018 |
| Token No | SM/18-19/905 11/09/2018 | Serial | 036 |
| Patient Name | Mrs. PALLABI APOT | Contact No | |
| Address | SERAMPORE | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/72 mmHg | Weight | KG |
| Pulse Rate | 70 / min | Height | cm |
| Diagnosis | |||