Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02366 | Date 27/06/2019 |
| Token No | SM/18-19/4494 27/06/2019 | Serial | 027 |
| Patient Name | Mrs. SUNANDA SEN | Contact No | NOT GIVEN |
| Address | 10 RUDRA RAM PANDIT LANE | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||