Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03755 | Date 22/01/2020 |
| Token No | SM/19-20/8452 22/01/2020 | Serial | 006 |
| Patient Name | Mrs. BASANTI CHATTERJEE | Contact No | NOT GIVEN |
| Address | 10 CHATTERJEE LANE | Age | 58 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||