Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03079 | Date 19/09/2019 |
| Token No | SM/18-19/6785 30/09/2019 | Serial | 010 |
| Patient Name | Mrs. SUPRIYA KUNDU | Contact No | 9432500773 |
| Address | 35/1 A K C BHATTACHARYA STREET | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||