Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02614 | Date 26/07/2019 |
| Token No | SM/18-19/5123 26/07/2019 | Serial | 002 |
| Patient Name | Mrs. NAYANTARA BASU | Contact No | 8001458920 |
| Address | 21 PANCHANAN TALA LANE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||