Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03370 | Date 14/11/2019 |
| Token No | SM/18-19/7386 14/11/2019 | Serial | 034 |
| Patient Name | Mrs. LAXMI HALDER | Contact No | 8240701061 |
| Address | 9/A RUDRA RAM PANDIT LANE | Age | 58 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||