Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00212 | Date 23/08/2018 |
| Token No | SM/18-19/952 14/09/2018 | Serial | 004 |
| Patient Name | Mrs. RABI KUSMA | Contact No | 9038731980 |
| Address | SERAMPORE COLLEGE | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||