Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03751 | Date 20/01/2020 |
| Token No | SM/19-20/8441 20/01/2020 | Serial | 005 |
| Patient Name | Mrs. MINAKSHI DEY | Contact No | NOT GIVEN |
| Address | 13/A PANCHANAN TALA LANE | Age | 57 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||