Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02469 | Date 11/07/2019 |
| Token No | SM/18-19/4747 11/07/2019 | Serial | 028 |
| Patient Name | Mrs. PRIYANKA RAJBHAR | Contact No | 9804021813 |
| Address | 16 KAILASH CHATTERJEE LANE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||