Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00265 | Date 11/08/2018 |
| Token No | SM/18-19/347 28/08/2018 | Serial | 014 |
| Patient Name | Mrs. REKHA DEY | Contact No | 8622032238 |
| Address | 90/C/3 DEY STREET | Age | 67 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||