Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 01988 | Date 26/04/2019 |
| Token No | SM/18-19/3420 26/04/2019 | Serial | 016 |
| Patient Name | Mrs. NIRUPAMA BISWAS | Contact No | 8420281865 |
| Address | 77 KHETRAMOHON SHA ST | Age | 27 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||