Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03136 | Date 27/09/2019 |
| Token No | SM/18-19/6769 27/09/2019 | Serial | 043 |
| Patient Name | Mrs. DIPTI KARMAKAR | Contact No | 7596898576 |
| Address | NALIKUL | Age | 28 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||