Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01312 | Date 29/11/2018 |
| Token No | SM/18-19/2867 19/03/2019 | Serial | 001 |
| Patient Name | Mrs. SIKHA PAL | Contact No | 8647849386 |
| Address | KALITALA | Age | 80 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||