Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02904 | Date 27/08/2019 |
| Token No | SM/18-19/5935 27/08/2019 | Serial | 015 |
| Patient Name | Mrs. RANJU DEVI | Contact No | 8013548536 |
| Address | 4 DEY GHAT LANE | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||