Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02135 | Date 28/05/2019 |
| Token No | SM/18-19/3924 03/06/2019 | Serial | 013 |
| Patient Name | Mrs. LALTI DEVI | Contact No | 9748923834 |
| Address | 16 AKC BHATTCHARJEE | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||