Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03485 | Date 28/11/2019 |
| Token No | SM/19-20/7702 28/11/2019 | Serial | 004 |
| Patient Name | Mrs. TULABATI DEBNATH | Contact No | 9547820497 |
| Address | BHAGIRATHI LANE | Age | 25 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||