Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00939 | Date 13/02/2020 |
| Token No | SM/19-20/2235 14/02/2020 | Serial | 020 |
| Patient Name | Mrs. KOYENA DEY | Contact No | 8697119592 |
| Address | Age | 18 Y Female | |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||