Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02254 | Date 13/06/2019 |
| Token No | SM/18-19/4140 13/06/2019 | Serial | 030 |
| Patient Name | Mrs. SARASWATI DEBI | Contact No | 7003800575 |
| Address | 70 AKHRA BATI LANE | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||