Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01296 | Date 22/11/2018 |
| Token No | SM/19-20/7844 03/12/2019 | Serial | 012 |
| Patient Name | Mrs. KAKOLI MUKHERJEE | Contact No | 9836290644 |
| Address | 29 DOSTI LAMNE | Age | 49 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 84 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||