Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00366 | Date 13/08/2018 |
| Token No | SM/18-19/415 13/08/2018 | Serial | 022 |
| Patient Name | Mrs. KALAWATI DEVI | Contact No | 7044131086 |
| Address | 9 NO GATE NAYA BAGAN | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||