Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01269 | Date 01/11/2018 |
| Token No | SM/18-19/4102 11/06/2019 | Serial | 033 |
| Patient Name | Miss DURGA DEBI | Contact No | 7003693465 |
| Address | 3B DEY STREET | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||