Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03419 | Date 18/11/2019 |
| Token No | SM/19-20/7868 05/12/2019 | Serial | 018 |
| Patient Name | Mrs. BHARATI KUNDU | Contact No | 9007277341 |
| Address | NANILAL BHATTACHARYA ST | Age | 77 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||