Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00035 | Date 03/08/2018 |
| Token No | SM/18-19/1268 27/09/2018 | Serial | 008 |
| Patient Name | Mrs. DEOKI JENNA | Contact No | 9007258708 |
| Address | 45 N L BHATTACHARJEE STREET | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||