Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02364 | Date 27/06/2019 |
| Token No | SM/18-19/7455 16/11/2019 | Serial | 005 |
| Patient Name | Mrs. PRIYANKA RAM | Contact No | 6290114859 |
| Address | 17/A/12 CHOWDHURY PARA LANE | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||