Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03049 | Date 16/09/2019 |
| Token No | SM/18-19/6453 16/09/2019 | Serial | 013 |
| Patient Name | Miss ALOKA RAJBHAR | Contact No | 9038651062 |
| Address | 79 DEY STREET | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||