Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03283 | Date 24/10/2019 |
| Token No | SM/18-19/7147 24/10/2019 | Serial | 007 |
| Patient Name | Mrs. MONALISA PAL | Contact No | 6291355343 |
| Address | 86 DEY STREET | Age | 34 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||