Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03503 | Date 29/11/2019 |
| Token No | SM/19-20/7761 29/11/2019 | Serial | 024 |
| Patient Name | Mrs. CHANDRIMA KUNDU | Contact No | 9830959238 |
| Address | 17/A/1 CHOWDHURY PARA LANE | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 86 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||