Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01901 | Date 09/04/2019 |
| Token No | SM/18-19/6501 17/09/2019 | Serial | 001 |
| Patient Name | Mrs. SOVA DEY | Contact No | 9163552914 |
| Address | KAILASH CHATTERJEE LANE | Age | 70 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||