Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01309 | Date 27/11/2018 |
| Token No | SM/18-19/1831 27/11/2018 | Serial | 019 |
| Patient Name | Mrs. SHOVA DUTTA | Contact No | 9836875253 |
| Address | 550 G.T ROAD | Age | 56 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||