Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02423 | Date 08/07/2019 |
| Token No | SM/18-19/4639 08/07/2019 | Serial | 006 |
| Patient Name | Mrs. TUNNI DEBI | Contact No | NOT GIVEN |
| Address | 1 INDIA JUTE MILL | Age | 23 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||