Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03277 | Date 23/10/2019 |
| Token No | SM/18-19/7131 23/10/2019 | Serial | 002 |
| Patient Name | Mrs. SOVA DUTTA | Contact No | 8334928134 |
| Address | 3/A BROJODUTTA LANE | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||