Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00303 | Date 25/10/2019 |
| Token No | SM/19-20/678 15/11/2019 | Serial | 014 |
| Patient Name | Mrs. SWAPNA CHAKRABORTY | Contact No | 8240267398 |
| Address | 162/X/D TARAPUKUR GOVT QUARTER | Age | 65 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||