Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02977 | Date 03/09/2019 |
| Token No | SM/18-19/6167 03/09/2019 | Serial | 014 |
| Patient Name | Mrs. BIDYA KOIRI | Contact No | NOT GIVEN |
| Address | PACHU BABU BAZAR | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||