Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02396 | Date 02/07/2019 |
| Token No | SM/18-19/4576 02/07/2019 | Serial | 006 |
| Patient Name | Mrs. KANCHANA PRADHAN | Contact No | NOT GIVEN |
| Address | N L BHATTACHARYA STREET | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||