Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01778 | Date 10/03/2019 |
| Token No | SM/18-19/2815 13/03/2019 | Serial | 005 |
| Patient Name | Mrs. VIDYA DEBI | Contact No | NOT GIVEN |
| Address | 9 DEY STREET | Age | 60 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||