Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02318 | Date 20/06/2019 |
| Token No | SM/18-19/4310 20/06/2019 | Serial | 013 |
| Patient Name | Mrs. MAMONI BAIRAGI | Contact No | 6291339986 |
| Address | 28 B PANCHANAN TALA LANE | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||