Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03627 | Date 16/12/2019 |
| Token No | SM/19-20/8106 16/12/2019 | Serial | 037 |
| Patient Name | Mrs. BIDYA DEBI | Contact No | NOT GIVEN |
| Address | 10 DEY GHAT LANE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||