Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00313 | Date 28/08/2018 |
| Token No | SM/18-19/6677 24/09/2019 | Serial | 032 |
| Patient Name | Mrs. JAYANTI DEY | Contact No | 8910576668 |
| Address | DEY STREET | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||