Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02706 | Date 02/08/2019 |
| Token No | SM/18-19/5368 02/08/2019 | Serial | 028 |
| Patient Name | Mrs. SANJU DEVI | Contact No | 7463963488 |
| Address | AKC BHATTACHARAYA STREET | Age | 27 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||