Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02511 | Date 19/07/2019 |
| Token No | SM/18-19/4881 19/07/2019 | Serial | 016 |
| Patient Name | Mrs. MAMATA SINGHA | Contact No | 9331623210 |
| Address | 11 BRAJA DUTTA LANE | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||