Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03760 | Date 24/01/2020 |
| Token No | SM/19-20/8469 24/01/2020 | Serial | 011 |
| Patient Name | Mrs. KRISHNA DEY | Contact No | 9432166269 |
| Address | 75 DEY STREET | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||