Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02606 | Date 25/07/2019 |
| Token No | SM/18-19/5114 25/07/2019 | Serial | 019 |
| Patient Name | Mrs. ANJU MARA | Contact No | 9661794286 |
| Address | GOALA PARA, RISHRA | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||