Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03933 | Date 18/03/2020 |
| Token No | SM/19-20/8721 18/03/2020 | Serial | 003 |
| Patient Name | Mrs. DIPALI BOSE | Contact No | NOT GIVEN |
| Address | 8 A.B. GARDEN L;ANE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||