Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03265 | Date 22/10/2019 |
| Token No | SM/18-19/7334 11/11/2019 | Serial | 018 |
| Patient Name | Mrs. SABITRI DEY | Contact No | 6290892721 |
| Address | 13 DHARMATALA | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||