Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02076 | Date 17/05/2019 |
| Token No | SM/18-19/3698 17/05/2019 | Serial | 002 |
| Patient Name | Mrs. JHARNA DEY | Contact No | 7044262485 |
| Address | 9 ANNADABABU GARDEN LANE | Age | 62 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||