Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01661 | Date 14/02/2019 |
| Token No | SM/18-19/7664 22/11/2019 | Serial | 023 |
| Patient Name | Mrs. LALMONI DEBI | Contact No | 7890275798 |
| Address | 79 DEY STREET | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||