Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00277 | Date 30/09/2019 |
| Token No | SM/19-20/418 30/09/2019 | Serial | 042 |
| Patient Name | Mrs. LILA PAL | Contact No | 7890786987 |
| Address | 18 TARAPUKUR LANE | Age | 75 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||