Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03530 | Date 02/12/2019 |
| Token No | SM/19-20/7815 02/12/2019 | Serial | 020 |
| Patient Name | Mrs. RUPA CHOWDHURI | Contact No | 9681620308 |
| Address | 7A DEY GHAT LANE | Age | 28 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||