Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03444 | Date 20/11/2019 |
| Token No | SM/18-19/7575 20/11/2019 | Serial | 032 |
| Patient Name | Miss INDU SHA | Contact No | 8981993389 |
| Address | 2 BECHU DEY LANE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||