Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02989 | Date 05/09/2019 |
| Token No | SM/18-19/6230 05/09/2019 | Serial | 012 |
| Patient Name | Mrs. ARATI DEBNATH | Contact No | 8697044053 |
| Address | 39 PATUA PARA | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||