Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03004 | Date 06/09/2019 |
| Token No | SM/19-20/8299 07/01/2020 | Serial | 030 |
| Patient Name | Mrs. TRIPTI CHATTERJEE | Contact No | 8777024989 |
| Address | 71 THAKUR BATI STREET | Age | 49 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||