Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01839 | Date 29/03/2019 |
| Token No | SM/18-19/7327 11/11/2019 | Serial | 011 |
| Patient Name | Mrs. SUMITA DEY | Contact No | 9836752495 |
| Address | 4C DEY ST | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||