Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01930 | Date 18/04/2019 |
| Token No | SM/18-19/3621 13/05/2019 | Serial | 015 |
| Patient Name | Mrs. KANCHAN KAR | Contact No | 9874391085 |
| Address | 118 G.T ROAD | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||