Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 00302 | Date 28/08/2018 |
| Token No | SM/19-20/8802 07/07/2020 | Serial | 002 |
| Patient Name | Mrs. MILI CHATTERJEE | Contact No | 8017829886 |
| Address | 59A BHAGIRATHI LANE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||