Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02417 | Date 05/07/2019 |
| Token No | SM/18-19/4730 11/07/2019 | Serial | 011 |
| Patient Name | Mrs. HIRA DEBI | Contact No | 6291511264 |
| Address | 6 RAM SITA LANE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||