Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02117 | Date 27/05/2019 |
| Token No | SM/18-19/3810 27/05/2019 | Serial | 013 |
| Patient Name | Mrs. SOMA BHAR | Contact No | 9163798134 |
| Address | 78/A/1 DEY ST | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||