Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 03279 | Date 23/10/2019 |
| Token No | SM/18-19/7135 23/10/2019 | Serial | 006 |
| Patient Name | Mrs. KALYANI DUTTA | Contact No | 9051717921 |
| Address | BAISHNAB PARA 2 ND LANE | Age | 49 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||