Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02643 | Date 29/07/2019 |
| Token No | SM/18-19/5217 29/07/2019 | Serial | 027 |
| Patient Name | Mrs. DEVI DUTTA | Contact No | 9903144373 |
| Address | 36 NO KASHI DOCTOR LANE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||