Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02141 | Date 30/05/2019 |
| Token No | SM/18-19/3921 03/06/2019 | Serial | 010 |
| Patient Name | Mrs. SABITA KUNDU | Contact No | NOT GIVEN |
| Address | 35 a k c bhattacharya st | Age | 82 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||