Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02777 | Date 09/08/2019 |
| Token No | SM/18-19/6926 15/10/2019 | Serial | 018 |
| Patient Name | Mrs. KRISHNA DEBI PRADHAN | Contact No | 9432819935 |
| Address | 2 GOPAL GANGULY LANE | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||