Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01404 | Date 18/12/2018 |
| Token No | SM/18-19/4995 20/07/2019 | Serial | 005 |
| Patient Name | Miss SIKHA MURMU | Contact No | |
| Address | INDIAN JUTE MILE | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||