Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 01765 | Date 08/03/2019 |
| Token No | SM/18-19/2829 13/03/2019 | Serial | 019 |
| Patient Name | Mrs. BASANTI SURAI | Contact No | 8820616154 |
| Address | 12 RAILAND ROAD | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||