Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01588 | Date 17/01/2019 |
| Token No | SM/18-19/4138 13/06/2019 | Serial | 028 |
| Patient Name | Mrs. KAMALA PRADHAN | Contact No | 9748231069 |
| Address | 9 NO LINE JUTE MILL | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||