Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03480 | Date 26/11/2019 |
| Token No | SM/19-20/7677 26/11/2019 | Serial | 006 |
| Patient Name | Mrs. NIRMALA SINGH | Contact No | 9830290503 |
| Address | DEY STREET, PAL BAGAN | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||