Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01539 | Date 03/01/2019 |
| Token No | SM/18-19/2182 03/01/2019 | Serial | 003 |
| Patient Name | Mrs. MANISHA DEY | Contact No | NOT GIVEN |
| Address | 7 NO DEY STREET | Age | 48 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 180/100 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||