Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02639 | Date 29/07/2019 |
| Token No | SM/18-19/5209 29/07/2019 | Serial | 019 |
| Patient Name | Mrs. SUMITA DEY | Contact No | 943306653 |
| Address | 4 DEY STREET | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||