Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01302 | Date 27/11/2018 |
| Token No | SM/18-19/3221 12/04/2019 | Serial | 014 |
| Patient Name | Mrs. ARUNA DEBI | Contact No | 9331326648 |
| Address | N L BHATTACHARJEE STREET | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||