Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03413 | Date 18/11/2019 |
| Token No | SM/18-19/7472 18/11/2019 | Serial | 014 |
| Patient Name | Miss MOUSUMI DEBNATH | Contact No | 8697358578 |
| Address | 26 AKHRA BATI LANE | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||