Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02696 | Date 02/08/2019 |
| Token No | SM/18-19/5348 02/08/2019 | Serial | 008 |
| Patient Name | Mrs. CHHAYA RANI LAHA | Contact No | 9836875894 |
| Address | 29 B GOBIONDO BHATTACHARYA LANE | Age | 71 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||