Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03396 | Date 15/11/2019 |
| Token No | SM/19-20/8027 12/12/2019 | Serial | 015 |
| Patient Name | Mrs. SANGJUKTA BAKSHI | Contact No | 9432543455 |
| Address | 2B KAILASH CHATTERJEE LANE | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||