Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01914 | Date 11/04/2019 |
| Token No | SM/18-19/3188 11/04/2019 | Serial | 010 |
| Patient Name | Mrs. CHHABI DAS | Contact No | 8981218370 |
| Address | 573 G T ROAD, MANIKTALA | Age | 53 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||