Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02324 | Date 20/06/2019 |
| Token No | SM/18-19/4569 01/07/2019 | Serial | 032 |
| Patient Name | Mrs. RITA DEY | Contact No | 9804028776 |
| Address | 8/B DEY ST | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||