Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03643 | Date 19/12/2019 |
| Token No | SM/19-20/8148 26/12/2019 | Serial | 003 |
| Patient Name | Miss SONALI DAS | Contact No | 7980367205 |
| Address | 16A KAILASH CH. CHATTERJEE LANE | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||