Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02649 | Date 29/07/2019 |
| Token No | SM/18-19/5228 29/07/2019 | Serial | 038 |
| Patient Name | Mrs. SANDHYA NANDY | Contact No | 9836381853 |
| Address | 38 NO P.K.BHATTACHARYA LANE | Age | 76 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||