Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01784 | Date 12/03/2019 |
| Token No | SM/18-19/2790 12/03/2019 | Serial | 006 |
| Patient Name | Mrs. PUSHPA DUTTA | Contact No | 9830522953 |
| Address | 54 G.T. ROAD | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||