Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03500 | Date 29/11/2019 |
| Token No | SM/19-20/7756 29/11/2019 | Serial | 019 |
| Patient Name | Mrs. PAMPA BISWAS | Contact No | 9804941971 |
| Address | 1A KASHI DAKTAR LANE | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||