Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 01313 | Date 29/11/2018 |
| Token No | SM/18-19/2065 20/12/2018 | Serial | 013 |
| Patient Name | Mrs. ALPANA NATH | Contact No | 8647849386 |
| Address | KALITALA | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||