Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02294 | Date 18/06/2019 |
| Token No | SM/18-19/4254 18/06/2019 | Serial | 008 |
| Patient Name | Mrs. TAPASI KUNDU | Contact No | 8697361681 |
| Address | 584 G T ROAD, MANIKTALA | Age | 53 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||