Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00154 | Date 16/09/2019 |
| Token No | SM/19-20/168 16/09/2019 | Serial | 032 |
| Patient Name | Mrs. SANDIPA MONDAL | Contact No | 8420782025 |
| Address | TINBAZAR,SERAMPORE | Age | 19 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||