Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01836 | Date 29/03/2019 |
| Token No | SM/18-19/3699 17/05/2019 | Serial | 003 |
| Patient Name | Mrs. SUBHRA SAHA | Contact No | 7240774585 |
| Address | 75 DEY ST | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||