Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03610 | Date 14/12/2019 |
| Token No | SM/19-20/8060 14/12/2019 | Serial | 015 |
| Patient Name | Mrs. SUMITA CHOWDHURY | Contact No | NOT GIVEN |
| Address | 2 BECHU DE LANE | Age | 38 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||