Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02831 | Date 19/08/2019 |
| Token No | SM/18-19/5694 19/08/2019 | Serial | 002 |
| Patient Name | Mrs. SWAPNA PAL | Contact No | 9836795182 |
| Address | 78 K M SHA STREET | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||