Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02787 | Date 13/08/2019 |
| Token No | SM/18-19/5775 20/08/2019 | Serial | 043 |
| Patient Name | Miss MOUSUMI KUNDU | Contact No | 9163159435 |
| Address | 35 ACHARYA K C BHATTACHARYA STREET | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||