Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02745 | Date 06/08/2019 |
| Token No | SM/19-20/7922 06/12/2019 | Serial | 036 |
| Patient Name | Mrs. JYOTSNA DUTTA | Contact No | 9836248773 |
| Address | 537 D G T ROAD | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||