Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01618 | Date 05/02/2019 |
| Token No | SM/18-19/3550 07/05/2019 | Serial | 004 |
| Patient Name | Mrs. SANDHYA PAL | Contact No | 9038941200 |
| Address | THAKUR BATI STREET | Age | 59 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||