Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00484 | Date 20/08/2018 |
| Token No | SM/18-19/2365 07/02/2019 | Serial | 006 |
| Patient Name | Mrs. KRISHNA SETH | Contact No | 9433641551 |
| Address | 10 CHATTERJEE LANE | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||