Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02118 | Date 27/05/2019 |
| Token No | SM/18-19/3811 27/05/2019 | Serial | 014 |
| Patient Name | Mrs. JOLLY DEY | Contact No | 7278409766 |
| Address | 89/C DEY ST | Age | 41 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||