Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03231 | Date 18/10/2019 |
| Token No | SM/18-19/7013 18/10/2019 | Serial | 038 |
| Patient Name | Mrs. JYOTSNA BAG | Contact No | 8273078703 |
| Address | 3 ANNADA BABU GARDEN LANE | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||