Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00296 | Date 23/10/2019 |
| Token No | SM/19-20/463 23/10/2019 | Serial | 005 |
| Patient Name | Mrs. TANIYA LAHA | Contact No | 7890490882 |
| Address | 46 NO DEY BAGAN SERAMPORE | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||