Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03588 | Date 09/12/2019 |
| Token No | SM/19-20/7972 09/12/2019 | Serial | 045 |
| Patient Name | Mrs. SUJATA MALLICK | Contact No | 9339931688 |
| Address | 12 PTAMBAR DEY LANE | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||