Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03549 | Date 05/12/2019 |
| Token No | SM/19-20/7864 05/12/2019 | Serial | 014 |
| Patient Name | Mrs. TUMPA KARMAKAR | Contact No | 9836180543 |
| Address | 56 THAKUR BATI STREET | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||