Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03325 | Date 05/11/2019 |
| Token No | SM/18-19/7429 15/11/2019 | Serial | 028 |
| Patient Name | Mrs. BANALATA KUNDU | Contact No | |
| Address | Age | 66 YRS Female | |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||