Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03436 | Date 19/11/2019 |
| Token No | SM/18-19/7536 19/11/2019 | Serial | 033 |
| Patient Name | Mrs. MANJU SWARNAKAR | Contact No | 9477515739 |
| Address | KALITALA | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||