Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03496 | Date 29/11/2019 |
| Token No | SM/19-20/7741 29/11/2019 | Serial | 004 |
| Patient Name | Mrs. SAROJINI PRADHAN | Contact No | 8981501507 |
| Address | 12 PITAMBAR DEY LANE | Age | 38 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||