Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01854 | Date 02/04/2019 |
| Token No | SM/18-19/3015 02/04/2019 | Serial | 025 |
| Patient Name | Mrs. MALABIKA DAS | Contact No | 9073337395 |
| Address | 45 DEY ST | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||