Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01638 | Date 08/02/2019 |
| Token No | SM/18-19/5158 26/07/2019 | Serial | 037 |
| Patient Name | Mrs. SHYAMOLI DEY | Contact No | 8478914125 |
| Address | 4 CHOWDHURI PARA LANE | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||