Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01849 | Date 02/04/2019 |
| Token No | SM/18-19/3002 02/04/2019 | Serial | 012 |
| Patient Name | Mrs. NIBHA KUNDU | Contact No | |
| Address | THAKUR BATI ST | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||