Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00710 | Date 10/01/2020 |
| Token No | SM/19-20/1512 10/01/2020 | Serial | 006 |
| Patient Name | Mrs. APARNA DEY | Contact No | |
| Address | 30/A/1 CHATRA SERAMPORE | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||