Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02916 | Date 27/08/2019 |
| Token No | SM/18-19/5978 27/08/2019 | Serial | 058 |
| Patient Name | Mrs. SIKHA MAJUMDAR | Contact No | NOT GIVEN |
| Address | RAJHA DHARPUR | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||