Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 02871 | Date 22/08/2019 |
| Token No | SM/18-19/5824 22/08/2019 | Serial | 002 |
| Patient Name | Miss RINKU BHUIYA | Contact No | 9883968587 |
| Address | J N LAHIRI ROAD | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||