Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01283 | Date 16/11/2018 |
| Token No | SM/18-19/1771 16/11/2018 | Serial | 004 |
| Patient Name | Mrs. CHANDANA MONDAL | Contact No | 8334827354 |
| Address | 5 RUDRA RAM PANDIT LANE | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||