Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 01346 | Date 07/12/2018 |
| Token No | SM/18-19/4516 28/06/2019 | Serial | 006 |
| Patient Name | Mrs. PAPIYA BASU | Contact No | 9433272991 |
| Address | 501 G T ROAD MAHESH | Age | 48 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||