Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03035 | Date 13/09/2019 |
| Token No | SM/19-20/8723 18/03/2020 | Serial | 005 |
| Patient Name | Mrs. ANIMA DEY | Contact No | 9836640631 |
| Address | 4 DEY STREET | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||