Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 01753 | Date 07/03/2019 |
| Token No | SM/18-19/2787 12/03/2019 | Serial | 003 |
| Patient Name | Mrs. RUPALI ACHARYA | Contact No | 9163184498 |
| Address | 18 G C BHATTACHARYA LANE | Age | 38 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||