Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01599 | Date 22/01/2019 |
| Token No | SM/18-19/7110 22/10/2019 | Serial | 025 |
| Patient Name | Mrs. SANDHYA PAKIRA | Contact No | 7890241129 |
| Address | CHOWDHURY PARA | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||