Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02467 | Date 11/07/2019 |
| Token No | SM/18-19/4745 11/07/2019 | Serial | 026 |
| Patient Name | Mrs. MANTI DEBI | Contact No | 8335862752 |
| Address | 6 RAMSITA LANE | Age | 58 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||