Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01902 | Date 09/04/2019 |
| Token No | SM/18-19/3238 16/04/2019 | Serial | 007 |
| Patient Name | Miss BHARATI SHRIMANI | Contact No | 9836663957 |
| Address | 6B BECHU DEY LANE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||