Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03199 | Date 17/10/2019 |
| Token No | SM/18-19/6948 17/10/2019 | Serial | 009 |
| Patient Name | Mrs. ANJANA DE | Contact No | 9239437648 |
| Address | 107G PATUA PARA | Age | 36 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||