Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00056 | Date 09/09/2019 |
| Token No | SM/19-20/572 05/11/2019 | Serial | 040 |
| Patient Name | Mrs. ARPITA SARKAR | Contact No | 9007706147 |
| Address | 35 PRABASHNAGAR | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||