Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 02115 | Date 27/05/2019 |
| Token No | SM/18-19/3807 27/05/2019 | Serial | 010 |
| Patient Name | Mrs. JHIMALI SAHA | Contact No | 9038627088 |
| Address | 6/13 BAISNAB PARA MAHESH | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||