Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02547 | Date 19/07/2019 |
| Token No | SM/18-19/4961 19/07/2019 | Serial | 002 |
| Patient Name | Mrs. MOHUYA PAL | Contact No | 9433360421 |
| Address | 18 PANCHANAN TALA LANE | Age | 35 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||