Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03102 | Date 23/09/2019 |
| Token No | SM/18-19/6626 23/09/2019 | Serial | 028 |
| Patient Name | Mrs. MADHUMITA DEY | Contact No | 9330107676 |
| Address | 26 THAKUR BATI STREET | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||