Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02027 | Date 03/05/2019 |
| Token No | SM/18-19/3534 03/05/2019 | Serial | 012 |
| Patient Name | Mrs. JAYANTI DE | Contact No | 7278962224 |
| Address | 8/D/3 DEY ST | Age | 69 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||