Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03353 | Date 11/11/2019 |
| Token No | SM/18-19/7345 11/11/2019 | Serial | 029 |
| Patient Name | Mrs. JOYSHREE CHAUDHURI | Contact No | 26526202 |
| Address | 17/3 CHOWDHURI PARA LANE | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||