Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01718 | Date 26/02/2019 |
| Token No | SM/18-19/5560 09/08/2019 | Serial | 009 |
| Patient Name | Mrs. TAMASA GORAI | Contact No | 7890986500 |
| Address | 8/D DEY STREET | Age | 41 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||