Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02509 | Date 19/07/2019 |
| Token No | SM/18-19/5104 25/07/2019 | Serial | 009 |
| Patient Name | Mrs. R SRIDEVI | Contact No | 8013734489 |
| Address | 44B/2 N L BHATTACHARJEE STREET | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||