Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02690 | Date 01/08/2019 |
| Token No | SM/18-19/5334 01/08/2019 | Serial | 025 |
| Patient Name | Miss MOUSUMI DAS | Contact No | 8017058152 |
| Address | 90 C/B DEY STREET | Age | 20 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||