Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02897 | Date 26/08/2019 |
| Token No | SM/18-19/6383 12/09/2019 | Serial | 030 |
| Patient Name | Mrs. TANDRA SARKAR | Contact No | 8478960933 |
| Address | 11B/1 RAM SITA LANE | Age | 36 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||