Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03252 | Date 21/10/2019 |
| Token No | SM/18-19/7076 21/10/2019 | Serial | 043 |
| Patient Name | Mrs. MANJU APAT | Contact No | 9804554033 |
| Address | 44B/5 N L BHATTACHARYA STREET | Age | 34 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||