Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 02943 | Date 30/08/2019 |
| Token No | SM/18-19/6067 30/08/2019 | Serial | 050 |
| Patient Name | Miss MOUSTUSI DAS | Contact No | 7890203340 |
| Address | 14 J N LAHIRI ROAD | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||