Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01997 | Date 29/04/2019 |
| Token No | SM/24-25/18010 08/08/2024 | Serial | 001 |
| Patient Name | Mrs. CHAMELI ROY | Contact No | 8697318143 |
| Address | 18 PANCHANAN TALA LANE | Age | 45 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||