Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01610 | Date 01/02/2019 |
| Token No | SM/18-19/2336 01/02/2019 | Serial | 008 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 8276804314 |
| Address | 40 DOSTI LANE | Age | 80 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||