Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02528 | Date 22/07/2019 |
| Token No | SM/19-20/8208 03/01/2020 | Serial | 006 |
| Patient Name | Mrs. JAYANTI DAS | Contact No | 6289265916 |
| Address | 30/34 TARAPUKUR LANE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||