Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03047 | Date 16/09/2019 |
| Token No | SM/18-19/6555 19/09/2019 | Serial | 015 |
| Patient Name | Mrs. DEMANTI DAS | Contact No | NOT GIVEN |
| Address | 10 SEN BARI | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||