Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01081 | Date 13/09/2018 |
| Token No | SM/18-19/1407 13/09/2018 | Serial | 001 |
| Patient Name | Mrs. MAHUYA DAS | Contact No | 9836052470 |
| Address | SIRISH TALA | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||