Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01966 | Date 23/04/2019 |
| Token No | SM/18-19/7594 21/11/2019 | Serial | 015 |
| Patient Name | Mrs. ANNAPURNA DE | Contact No | 9239437648 |
| Address | 107G PATUA PARA LANE | Age | 68 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||