Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01670 | Date 14/02/2019 |
| Token No | SM/18-19/2549 21/02/2019 | Serial | 017 |
| Patient Name | Mrs. SHOVA SETH | Contact No | 8100375838 |
| Address | 10 CHATTERJEE LANE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||