Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01310 | Date 27/11/2018 |
| Token No | SM/18-19/4776 15/07/2019 | Serial | 022 |
| Patient Name | Mrs. PRAVAWATI DEVI | Contact No | 8274941168 |
| Address | DEY STREET | Age | 56 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||