Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03244 | Date 21/10/2019 |
| Token No | SM/18-19/7056 21/10/2019 | Serial | 023 |
| Patient Name | Mrs. PADMINI BERA | Contact No | NOT GIVEN |
| Address | 2 PANCHANAN TALA LANE | Age | 62 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||