Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02412 | Date 05/07/2019 |
| Token No | SM/18-19/4607 05/07/2019 | Serial | 015 |
| Patient Name | Mrs. APARNA DUTTA | Contact No | 8670610108 |
| Address | 5 BROJO DUTTA LANE | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||