Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01262 | Date 01/11/2018 |
| Token No | SM/18-19/1733 01/11/2018 | Serial | 010 |
| Patient Name | Mrs. INDU DEBI | Contact No | 8335862712 |
| Address | 3 DEY GHAT LANE | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||