Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04003 | Date 14/08/2020 |
| Token No | SM/19-20/8833 14/08/2020 | Serial | 004 |
| Patient Name | Mrs. BANDANA RAKSHIT | Contact No | 8697607589 |
| Address | 153 THAKUR BATI STREET | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||