Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03504 | Date 29/11/2019 |
| Token No | SM/19-20/7762 29/11/2019 | Serial | 025 |
| Patient Name | Mrs. SANGITA DUTTA | Contact No | 7003876720 |
| Address | 27 CHOWDHURY PARA LANE | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||