Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02247 | Date 13/06/2019 |
| Token No | SM/18-19/4127 13/06/2019 | Serial | 017 |
| Patient Name | Mrs. SOVA DEVI | Contact No | NOT GIVEN |
| Address | K C BHATTACHARYA ST | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||