Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01045 | Date 05/10/2018 |
| Token No | SM/18-19/5631 14/08/2019 | Serial | 021 |
| Patient Name | Mrs. SUKLA MITRA | Contact No | 7044521830 |
| Address | 13 PANCHANAN TALA LANE | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||