Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01903 | Date 09/04/2019 |
| Token No | SM/18-19/3301 22/04/2019 | Serial | 006 |
| Patient Name | Mrs. MUKTI ROY | Contact No | 9830185804 |
| Address | 7 AKHRABATI LANE | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||