Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02244 | Date 13/06/2019 |
| Token No | SM/18-19/4124 13/06/2019 | Serial | 014 |
| Patient Name | Mrs. BANI DAS | Contact No | 9830391490 |
| Address | 5 AKHRA BATI LANE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||