Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02422 | Date 08/07/2019 |
| Token No | SM/18-19/4637 08/07/2019 | Serial | 004 |
| Patient Name | Mrs. SEPHALI DAS | Contact No | 8961663664 |
| Address | 15/A/1 PATUA PARA | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||