Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01542 | Date 03/01/2019 |
| Token No | SM/18-19/4624 05/07/2019 | Serial | 032 |
| Patient Name | Mrs. IVA KUNDU | Contact No | 9432381481 |
| Address | 92B DEY ST | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||