Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03012 | Date 06/09/2019 |
| Token No | SM/18-19/6304 06/09/2019 | Serial | 052 |
| Patient Name | Mrs. SHAMPA ADHIKARY | Contact No | 7005895680 |
| Address | K D B LANE | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||