Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02327 | Date 20/06/2019 |
| Token No | SM/18-19/7149 24/10/2019 | Serial | 009 |
| Patient Name | Mrs. MANJU DAS | Contact No | NOT GIVEN |
| Address | PAL BAGAN | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||