Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03508 | Date 29/11/2019 |
| Token No | SM/19-20/7769 29/11/2019 | Serial | 032 |
| Patient Name | Mrs. RAMAWATI DEBI | Contact No | NOT GIVEN |
| Address | 5 DEY GHAT LANE | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||