Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01976 | Date 25/04/2019 |
| Token No | SM/18-19/3390 25/04/2019 | Serial | 022 |
| Patient Name | Mrs. KAKALI SEN | Contact No | 9051731114 |
| Address | THAKUR BATI STREET | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||