Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03941 | Date 20/03/2020 |
| Token No | SM/19-20/8905 22/09/2020 | Serial | 016 |
| Patient Name | Mrs. RITA DUTTA | Contact No | 9051480241 |
| Address | 3A BROJO DUTTA LANE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||