Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03995 | Date 12/08/2020 |
| Token No | SM/19-20/8824 12/08/2020 | Serial | 006 |
| Patient Name | Mrs. NILAM CHAKRABORTY | Contact No | 8282946515 |
| Address | 10/A BRAJA DUTTA LANE | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||