Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02008 | Date 30/04/2019 |
| Token No | SM/18-19/3481 30/04/2019 | Serial | 022 |
| Patient Name | Mrs. SONA JAISWARA | Contact No | NOT GIVEN |
| Address | GOPAL CHANDRA GANGULY LANE | Age | 49 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||