Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02647 | Date 29/07/2019 |
| Token No | SM/18-19/5223 29/07/2019 | Serial | 033 |
| Patient Name | Mrs. JHARNA PAUL | Contact No | NOT GIVEN |
| Address | 94NO THAKUR BATI LANE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||