Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03394 | Date 15/11/2019 |
| Token No | SM/18-19/7433 15/11/2019 | Serial | 032 |
| Patient Name | Mrs. MONIKA DEY | Contact No | 8420352544 |
| Address | 4 K C BHATTCHARJEE STREET | Age | 52 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||