Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02302 | Date 18/06/2019 |
| Token No | SM/18-19/4419 25/06/2019 | Serial | 007 |
| Patient Name | Mrs. CHHAYA BHAR | Contact No | NOT GIVEN |
| Address | 8B NABA KRISHNA GUIN LANE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||