Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02736 | Date 06/08/2019 |
| Token No | SM/19-20/7753 29/11/2019 | Serial | 016 |
| Patient Name | Mrs. MITHU GHOSH | Contact No | 8697424800 |
| Address | 32/A BHAGIRATHI LANE | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||