Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 01511 | Date 22/12/2018 |
| Token No | SM/18-19/4663 08/07/2019 | Serial | 030 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 9836875894 |
| Address | 29 GOBINDO BHATTACHARYA LANE | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||