Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02150 | Date 30/05/2019 |
| Token No | SM/18-19/3874 30/05/2019 | Serial | 023 |
| Patient Name | Mrs. JAYA MITRA | Contact No | 9836730652 |
| Address | 14 PANCHANAN TALA LANE | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||