Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02503 | Date 18/07/2019 |
| Token No | SM/18-19/4856 18/07/2019 | Serial | 034 |
| Patient Name | Mrs. SUSMITA PAL | Contact No | 9007590632 |
| Address | MAHESH COLONY | Age | 28 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||