Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 03330 | Date 05/11/2019 |
| Token No | SM/18-19/7636 21/11/2019 | Serial | 057 |
| Patient Name | Mrs. MONI DEBI | Contact No | 9875383968 |
| Address | 82 J N LAHIRI ROAD | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||