Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02535 | Date 22/07/2019 |
| Token No | SM/18-19/4936 22/07/2019 | Serial | 029 |
| Patient Name | Miss ROSHMITA BISWAL | Contact No | 7980597123 |
| Address | 52 N.L. BHATTACHARYA ST | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||