Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02564 | Date 20/07/2019 |
| Token No | SM/18-19/5014 20/07/2019 | Serial | 024 |
| Patient Name | Mrs. CHHABI BISWAS | Contact No | NOT GIVEN |
| Address | 5 BECHDEY LANE | Age | 39 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||