Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03276 | Date 23/10/2019 |
| Token No | SM/18-19/7130 23/10/2019 | Serial | 001 |
| Patient Name | Mrs. SHIPRA KUNDU | Contact No | 9051856383 |
| Address | 9 KASHI DAKTAR LANE | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||