Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02774 | Date 08/08/2019 |
| Token No | SM/18-19/5536 08/08/2019 | Serial | 023 |
| Patient Name | Mrs. RAJMATI DEBI | Contact No | 9662217466 |
| Address | 11 KALIDAS BHATTACHARYA LANE | Age | 80 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||