Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02263 | Date 14/06/2019 |
| Token No | SM/18-19/4169 14/06/2019 | Serial | 027 |
| Patient Name | Mrs. SANAKA DEY | Contact No | 9836631174 |
| Address | DEY ST | Age | 47 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||