Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00208 | Date 17/08/2018 |
| Token No | SM/18-19/1933 11/12/2018 | Serial | 021 |
| Patient Name | Mrs. APARNA DE | Contact No | 8013682307 |
| Address | 8C/4 DEY STREET | Age | 62 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||