Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02029 | Date 03/05/2019 |
| Token No | SM/18-19/3539 03/05/2019 | Serial | 017 |
| Patient Name | Mrs. KARMI BHUIYA | Contact No | |
| Address | J.N.LAHIRI ROAD | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||