Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02361 | Date 27/06/2019 |
| Token No | SM/19-20/8354 13/01/2020 | Serial | 010 |
| Patient Name | Mrs. RATNA SEN | Contact No | 9038776199 |
| Address | 593 G T ROAD | Age | 58 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||