Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02964 | Date 01/09/2019 |
| Token No | SM/18-19/6290 06/09/2019 | Serial | 038 |
| Patient Name | Mrs. SANANDA PAL | Contact No | 9641291026 |
| Address | 11B J N LAHIRI ROAD | Age | 25 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||